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THE PROPER WAY TO LIFT THE BABY 



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THE BABY 



HIS CARE AND TRAINING 



By 
MARIANNA WHEELER 

Supt. of The Babies' Hospital, Neiv York 

since 1891, Graduate of the Training 

Schools of the Ne~w York Hospital 

and Sloan e Ma tern ity Hosp ita I 



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ILLUSTRATED 



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HARPER & BROTHERS PUBLISHERS 
NEW YORK AND LONDON M C M I V 






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Copyright, 1901, by Harper & Brothers. 

^4// rights reserved. 
November, 1901. 



CONTENTS 

OHAP. PAGE 

I. The Baby ... .'..-. 3 

II. Fresh Air and Ventilation . . 11 

III. The Nursery : Its Furnishings— 

The Nurse 24 

IV. The Baby's Bath and Clothing 39 

V. Sleep and Amusement .... 63 

VI. Infant Feeding t * V * .* . . 81 

VII. Contagion — Measles and Scar- 

let Fever 114 

VIII. Diphtheria, Whooping - Cough, 

Mumps, and Chicken-Pox . . 137 

IX. Emergencies 162 

Index . 183 



ILLUSTRATIONS 



THE PROPER WAY TO LIFT THE 

BABY 

WINDOW-BOARD 

SCREEN 

RUBBER BATH-TUB ...... 

FLANNEL APRON 

BATH-TUB AND TABLE 

BATH THERMOMETER 

PLACING THE BABY IN THE TUB 

WOODEN TOOTH-PICK 

ABDOMINAL BAND 

THE BAND 

CANTON-FLANNEL DIAPER .... 

WRAPPED IN THE BATH BLANKET 
ONE-OUNCE TIN DIPPER .... 

PUTTING ON THE BAND .... 

NIPPLE .... ..... 

NURSING-BOTTLE . . 

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Frontispiece 


Page 


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Facing p. 


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Page 


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61 


Facing p. 


64 


Page 


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Facing p. 


96 


Page 


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105 



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ILLUSTRATIONS 

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PUTTING ON THE BABY'S DRESS Facing p. 128 

LOOKING DOWN THE BABY'S < 

THROAT . " 164/ 

SOFT RUBBER EAR SYRINGE . . Page 1 67 

V-SHAPED CUT FOR SPLINTER . . '' 173 

FOOT-BATH IN BED " 1 75 



THE BABY 

HIS CARE AND TRAINING 



CHAPTER I 

THE BABY 

AT the present time, when all branches 
■**■ of educational work are being ad- 
vanced and improved, one department seems 
to have been quite forgotten, and this is the 
education and preparation of the young 
woman for motherhood. Maternity in these 
days is often anticipated with dread instead 
of with the pleasure which should accom- 
pany the thought, and this is not surpris- 
ing when one realizes the ignorance of the 
average young mother as to the proper 
means of caring for her baby. The fact that 
nervous diseases are on the increase is true, 
and why? The chief cause is that the word 
moderation seems to be growing obsolete. 
This is especially true as regards the care 
and training of infants. It is the infant 
which makes the child, and the child the 
man. It is very unusual that a child is rwt 

3 



THE BABY 

born healthy. He is born without habits, 
good or bad — simply sent into this world 
innocent and helpless, his very life depen- 
dent upon others — and it is the parent whose 
pleasure it should be to guide this little life 
from its very first dawn to one of content- 
ment, health, and happiness. There is no 
reason why the young mother with one or 
several small children should succumb 
to her cares, become worn out, and deny 
herself all the pleasures which make life 
worth living. A mother owes a duty to 
herself and to her offspring, and this duty 
is to start from the very beginning with 
the infant's training. She should of her own 
knowledge know what is best for the baby. 
She should be the one who can direct the 
untutored maid, or, if she has a trained 
and experienced nurse, be independent 
even of that valuable person. It is not 
right that a mother should give her infant 
over to the care of any nurse, no matter 
how good she may be, and allow that person 
to undertake the entire training and guid- 
ing of this most important part of life. A 
right start in life means everything in 
the development of a healthy, whole- 

4 



THE BABY 

some, happy life later. With the baby 
use moderation. Never go to extremes in 
anything. Begin by being systematic and 
punctual. Have a time and place for ev- 
erything, and see that these rules are 
adhered to. The chief things to be con- 
sidered as absolutely essential to the 
well-being of the baby are exercise, air, 
food, cleanliness, sleep, and clothing. 

One of the first acts on the part of the 
doctor after a child is born into the world 
is to administer a smart spanking to 
him — for . the reason that in order to live 
it is necessary for the child to breathe. 
It is absolutely essential that the little 
lungs should be filled with air and be- 
come expanded to the utmost. If the 
spanking does not have the desired ef- 
fect, more effective measures are resorted 
to, such as plunging into alternate hot 
and cold baths, artificial respiration, etc. 
But one thing is certain — if the baby is 
to live he must cry, as it is only through 
a good cry that the lungs are expanded as 
they should be. When this is so neces- 
sary to life, it is not only selfish but wrong 
on the part of any parent to object to 

5 



THE BABY 

hearing the baby cry. It is only too 
often that the mother, in not wanting 
her child to cry, is simply considering 
her own nerves, humoring herself, and 
wilfully spoiling the child. Bad-tem- 
pered, stubborn, self-willed, and even 
delicate children are the result of this 
over-indulgence in infancy. The unfair- 
ness of this lack of training is shown 
later when punishment, corporeal and 
otherwise, is resorted to to subdue the 
strong will and naughtiness of the older 
child. He is not to blame for what you 
have made him, and under these circum- 
stances it is wrong to punish him. It is 
much easier to make a right start than to 
wait awhile and then try to correct faults 
which have already taken deep root. This 
is valuable time lost. It is not pleasant 
for you, and is unjust to the child. 

We will first, then, consider the cry of an 
infant. Let the mother not hush his cries 
by walking or rocking him ; this is a very 
bad habit. Instead of quieting, on the 
contrary it should be a mother's duty to 
insist that her baby indulges in a certain 
amount of good, healthy crying each day. 

6 



THE BABY 

A whining, fretful cry is not a beneficial 
one. It must be a good, strong, hearty 
cry; one during which the baby draws 
in a deep breath and holds it for a few 
seconds, thus expanding the little lungs 
to their fullest extent. It is this which 
strengthens and toughens the lung tissue. 
A child with lungs thus made strong and 
healthy does not catch cold easily. 

But here in the very start moderation 
and judgment must be exercised ; all 
cries of the infant are not alike, and a 
mother should as soon as possible learn 
to distinguish them. There is, first, the 
cry of nature, which is strong and lusty, 
in the course of which several good screams 
are given and the child becomes red in 
the face; this cry is wholesome, healthy, 
and an important part of the baby's ex- 
ercise. There is then the cry of temper or 
indulgence; this is when the child cries 
heartily, but instantly ceases when taken 
up, is rocked, or walked with, and is given 
whatever it wants and is crying for. In this 
case do not indulge the child, as, sooner 
or later, you will have cause for regret. 
But let him cry it out. This, once or twice 

7 



THE BABY 

at the most, is usually enough; you will 
find the cases are rare when the discipline 
has to be repeated. Then there is the cry of 
hunger, as when the child cries immediately 
after he has finished his food. This is 
rather a fretful, worrying cry, which is 
somewhat prolonged and frequent between 
the feedings; at the same time the infant 
will eagerly suck his fingers or part of 
his little fist. Again, there is the cry of 
pain, which is sharp and not continuous, 
but coming in paroxysms as the pain is 
felt and ceasing as the cause passes away. 
It is frequently accompanied by drawing 
up of the legs, as in colic ; or carrying the 
hands to the side of the head, if the pain is 
in the ears. When a child is really ill the 
cry is always more feeble; the child is 
irritable and frets from every little cause. 
In not one of these cries is the child bene- 
fited by rocking, walking, dancing him 
up and down, administering medicine, giv- 
ing food at irregular hours, a rubber or 
sugar-nipple to suck, or by constant amuse- 
ment ; if the cry be from a pain or sickness, 
these devices do not take away or ease 
the real cause; they may simply divert 

8 



THE BABY 

the infant for a few seconds, but even 
this is doubtful. And all this diversion is 
mostly at the expense of the nerves and 
stomach. If the mother or nurse is con- 
vinced that the cry is other than natural, 
the best and most sensible thing for her 
to do is to first make a thorough examin- 
ation of the infant, and try, if possible, to 
find the cause, and, in relieving that, thus 
really relieve the child. Among the pos- 
sible causes to be looked for are pins 
either sticking or pressing into the flesh, 
uncomfortable wrinkles in the clothes, 
colic, cold hands and feet, earache, and 
constipation. 

The constant handling of an infant is 
not good for him. The less he is lifted, 
held, and passed from one pair of hands 
to another, the better, as while he is so 
young his bones are soft, and constant 
handling does not tend to improve their 
development nor the shapeliness of his little 
body. The new-born infant should spend 
the greater part of his early life on the bed. 
An occasional change of position is, how- 
ever, advisable; but, in order to do this, 
much handling is not necessary. When 

9 



THE BABY 

the baby has lain long in one position, 
and perhaps become restless or tired 
from so doing, gently roll him over, if on 
the back, first on one side, then on 
the other ; and once in a while he may lie 
on his stomach. In this way the pressure 
is not confined to any one side or part of 
the body, but is evenly distributed on all 
sides, and the muscles develop equally 
all over the body. When necessary to 
take the baby up, never grasp the body 
by the hands to lift him, for in so doing 
one is apt to make pressure over the chest 
and abdomen, where the most delicate 
organs of the body lie. It is not only 
uncomfortable for the child, but there is 
also danger of doing injury to these or- 
gans. The way to lift a baby is to grasp 
the clothing with the right hand just be- 
low the feet, then extend the left hand 
along the spine, the palm supporting 
the back, the three middle fingers the 
head and neck. In this way the infant is 
lifted without any part of the body 
feeling pressure or strain. The clothing 
forms a little hammock, in which the child 
lies perfectly comfortable. 

10 



CHAPTER II 
FRESH AIR AND VENTILATION 

OINCE the infant must breathe, if he 
^ is to live, it is well to consider the 
quality of the air which he is to take into 
his lungs, and it is most important from 
the first that this air should be as free 
from impurities as possible. Pure, fresh 
air, and plenty of it, is absolutely essen- 
tial to a healthy baby. The lungs are 
strengthened by deep draughts of it, the 
blood purified, and the whole system 
benefited ; consequently, let the baby have 
fresh air every hour of the twenty-four. 
But remember that, while the air goes into 
the lungs pure, when it returns it comes 
back laden with impurities, which it car- 
ries from the blood. And it is not healthy 
to breathe this same air over and over 
again, any more than it is clean to bathe in 
the same water many times. In giving 

II 



THE BABY 

the child fresh air again, be moderate in the 
manner this necessary element is obtained. 
In order to get fresh air, do not think it 
necessary to turn the baby out of doors at 
all hours and seasons and in all kinds of 
weather, as much harm may thus be done, 
and many colds may be caught. Many 
throat and nose troubles are traced to 
this indiscriminate turning the child out 
of doors, as it were. It is just as impor- 
tant that the new-born baby have fresh 
air as the older child, but he should not 
get it in quite the same way. The young 
baby should not be immediately taken 
out of the house and into the open air, 
but the fresh air can be brought in the 
house to him. It is well to begin from the 
first day, and have the air in the nursery 
or room where the baby is kept most of 
the time changed frequently. Change 
the air not less than two or three times 
a day, and do not forget that not only the 
baby is breathing the air, but the nurse 
and other persons who are in the room 
or who come in to see the new wonder are 
each one helping to exhaust this supply. 
This airing can be accomplished by tak- 

12 



FRESH AIR AND VENTILATION 

ing the baby from the room at stated 
times and opening the windows, both 
upper and lower sash, for a short time. 
If when you are ready to bring the baby 
back the temperature of the room is not 
quite the degree it should be, keep him 
wrapped in a blanket or afghan for a 
while until the temperature rises. In 
very cold weather another and perhaps 
better way to obtain the required fresh- 
air supply is through a connecting room, 
which is to be aired and warmed; then 
open the door which leads into the nursery. 
But, either way, it is well to take the 
child out of his nursery entirely twice a 
day and give that room a thorough airing. 
It is well to begin early in life to accus- 
tom the infant to taking cool air into his 
lungs; the longer he breathes only the 
furnace-heated air of the house, just so 
much more sensitive to a colder atmos- 
phere will the lungs become. As the 
baby grows older take him out of doors, 
and, as the lungs have already become ac- 
customed to contact with cool air, you will 
have no need to fear colds. At first take 
the baby out for a short time only, but 

13 



THE BABY 

each day make the time he is in the open 
air longer, until he spends the greater 
part of each pleasant day out of doors. 
The days on which baby had best stay 
in the house and take his airing in the 
nursery are days when it is rainy, damp, or 
foggy ; days when the sun does not shine, 
and there is melting ice and snow on the 
ground. If the snow is melting in con- 
sequence of a warm, bright sun shining 
upon it, there is then no harm in sending 
the child out. Babies should not go out on 
days when there is a strong wind blowing. 
Especially is this true in cities, when, with 
high winds, the air is filled with the dust 
and filth of the streets. As a rule, a young 
infant should not be taken out in his car- 
riage when the thermometer is below 30 . 
But it would be far better to take babies 
out with the temperature much below this 
point, if the sun is shining, the air clear 
and dry and no wind, than on the days 
above described. 

When the weather is not suitable for the 
child to go out for his usual time, or only 
for a short part of the day, he should have 
his airing in some room in the house. Put 

14 



FRESH AIR AND VENTILATION 

on his out -door wraps, and lower the 
windows from the top. Do not open from 
the bottom, as then a direct current of 
air may blow upon the child. In this way 
let the child have the benefit of one, two, 
or three hours' fresh air without being ex- 
posed to the inclemency of the weather 
outside. The age at which an infant 
should be taken into the open air depends 
entirely upon the climate in which he lives 
and the season of the year. In summer; 
ordinarily the baby should not go out until 
he is three weeks old. In a northern climate 
even then care must be taken, especially 
if near the seashore, where the winds are 
strong. It is best that even light winds 
should not blow upon a new-born baby. 
Also, at this season, driving in an open car- 
riage is not desirable for an infant before 
he is three or four months old ; in the win- 
ter not at all. In the spring and autumn 
the baby can be taken out when he is 
about a month or six weeks old, but a 
baby born in mid-winter will often have 
to remain in the house until spring, unless 
the winter be a mild one, when, after six 
weeks, he can be taken out on mild days 

15 



THE BABY 

for a little while. These instructions ap- 
ply only to a northern climate. In the 
South, where it is much milder, under most 
circumstances a child can go out with 
safety at any time after the first two or 
three weeks. 

While we have considered only the ne- 
cessity of fresh air during the day, it is 
quite as important that a generous sup- 
ply should be had at night. A most em- 
inent general practitioner has made the 
statement " that, of the twenty-four hours, 
the night air is by far the purest/' But 
we must remember that at night we do not 
have the sun to warm and dry the air ; so 
it must be taken more sparingly, and in a 
different way, but must not be omitted 
altogether. The room in which a very 
young infant sleeps, if the weather be 
cold, can be well ventilated by opening a 
window in a connecting room, the door 
between the two, of course, being open, 
the severity of the weather deciding the 
question as to whether the window be 
opened little or much. But ordinarily, 
and, with older children, let the air come 
in through the window of the sleeping 

16 



FRESH AIR AND VENTILATION 

apartment. It is well to have two frames, 
as wide as the sash and about a foot to a 
foot and a half high, made to fit the win- 
dow-frame, top and bottom. Cover these 
with a coarse cheese cloth or muslin. 
They should be fastened in the window 
at night, when it is opened, as they tem- 
per any strong wind that may blow in, 
and act as a filter to keep out dampness, 
soot, and dust. It is not necessary to 
use these screens in summer. 

In summer the baby should not go out 
during the hottest part of the day — early 
morning is the best time for his airing. 
Take him from his bed, wash his face and 
hands, put a light flannel wrapper on 
over his night-dress, and take him out. 
He can finish his nap and have his break- 
fast out of doors. The early morning air 
in summer is sweet and refreshing, and 
a good tonic. As the sun creeps higher 
and the air becomes warmer you can then 
bring him in and give him his bath. 
He will then probably go to sleep again 
in the darkened nursery, thus affording 
the nurse a little time for rest or a nap, 
to make up for what she has lost by 

17 



THE BABY 

the early rising. If the weather is very 
warm, do not send the baby out again 
until late in the afternoon, when the air 
again becomes cooler. He can stay out 
during the early evening, but should al- 
ways be brought in before the dew begins 
to fall. During the spring and autumn 
the character of the day should govern the 
length of time he is to spend in the air. 
If the day be fair and dry, he can stay out 
most of the day between the hours of 9 
A.M. and 4 or 4.30 P.M. In the early 
spring it may not be wise to send the baby 
out quite as early as 9 o'clock, on account 
of the moisture which is caused by the frost 
coming out of the ground. It is, in this case, 
better to wait until towards noon, when the 
sun dries the pavement. And remember at 
this season to keep the baby on the sunny 
side of the street. In the autumn it may 
also not be prudent to keep him out as late 
as the time mentioned — 4 P.M. — as there is 
a dampness in the air which is caused by 
the accumulation of fallen and decaying 
leaves lying on the ground. During the 
winter it is best to send the baby out only 
between the hours of 10 A.M. and 3 P.M. 

18 



FRESH AIR AND VENTILATION 

When a child reaches the age of a year 
he can stand much colder air than a 
younger infant, and when he reaches the 
age of two or three, or when old enough 
to run about and exercise, he can go out 
in almost any kind of weather except 
that which is absolutely bad, as by this 
time his lungs have grown stronger and 
have much more resistance; they are not 
so easily affected by moisture; he does 
not lose his breath in a moderate gust of 
wind ; and his blood is not so easily chilled 
by the cold. Against the habit of keeping 
children too closely housed, or living in 
rooms overheated and badly, or not at all, 
ventilated, one cannot speak too strongly. 
It is not reasonable for any one to assume 
that the poisonous gases exhaled from 
the lungs are ever healthy for any one to 
breathe, much less an infant. If you 
would have your baby well developed, 
strong, and healthy, give him plenty of 
oxygen; let him have all he can get to 
breathe. This is true even in cases of 
pulmonary trouble. Children suffering 
from bronchitis and pneumonia stand a 
far better chance of getting well, or of a 

19 



THE BABY 

quick recovery, if the air in the sick-room 
is kept pure by frequent changes. This 
is best done by using the same means 
as suggested for very young infants, 
namely, through a connecting room. Do 
not be afraid of ever using this method of 
ventilation; you will find it as beneficial 
as medicine, if not more so. The germs 
of any disease will flourish in the impure 
atmosphere of a closed apartment, but 
will surely vanish where sunshine and 
fresh air come. 

To live out in the open air, even when 
the thermometer reaches many degrees 
below zero, is considered one of the best 
if not the only cure in these days for 
tuberculosis, the most serious of all lung 
diseases. Hot-house fruits and flowers 
are beautiful to look at, but I think there 
are few who will not agree that they lack 
the flavor, perfume, and life of those grown 
in the open air. And no mother can ever 
expect her baby to healthily develop and 
grow strong under hot-house conditions. 
In connection with the child's airing, it 
may be well to consider the question of 
wraps. As a rule, even in very cold 

20 



FRESH AIR AND VENTILATION 

weather, the majority of babies one meets 
on the street are entirely too warmly 
clad. The child who is sent out for his 
airing with fur rugs under him and another 
one over him, with fur about his cap and 
neck, is in a fair condition to have con- 
stant colds and to acquire chronic throat 
trouble. By his superabundance of wraps 
the pores of the skin are kept open, the 
surface of the body becomes moist, the 
child is made over-tender and sensitive to 
the slightest cold or waft of wind which 
blows upon him. He is equally liable to 
take cold when brought into the house and 
the wraps removed, for, from excessive per- 
spiring, the clothing has become damp. 
Without the heavy outer garments, the 
moisture-laden clothes soon become cold, 
striking a chill to the over-sensitive little 
body. This is wrong. Never overwrap 
the child when you send him out. A mod- 
erate amount of warm woollen wraps are all 
that are necessary. The quantity of cover- 
ing needed must be governed by the tem- 
perature outside, and it is not well for the 
mother to leave this to the nurse's judg- 
ment. A child should never be dressed 

21 



THE BABY 

so warmly as to cause it to perspire, 
especially while it is out of doors. In 
our variable climate it is always well 
to tuck an extra wrap somewhere in the 
baby's carriage in case of sudden change, 
as cold winds spring up or a dampness may 
arise in a very short time, and if the child 
be some distance from home this wrap will 
prove most useful. Before the child leaves 
the house, always see that hands and feet 
are warm. Never send a child out with 
cold extremities, as it is very easy for 
these small members to become chilled. 
In cold weather it is well to put a hot- 
water bag in the carriage, not too near the 
feet, but a little distance from them; the 
heat which radiates from the bag will 
keep the feet and legs warm. Warm 
mittens should cover the hands, coming 
up high enough to protect the wrists. In 
very cold weather the hands should be 
tucked under the afghan or blanket. 
While the baby is out, remembei never to 
let the wind blow in his face nor the sun 
shine in his eyes; neither allow him to 
lie on his back with the strong light from 
the sky above reflected full in the face, 

22 



FRESH AIR AND VENTILATION 

especially if the sky be somewhat over- 
cast, as this causes a white light which is 
especially injurious to the eyes. Care- 
lessness in this respect is the cause of 
much eye trouble, and not infrequently per- 
manently injures the sight. Every baby 
carriage should be provided with a parasol, 
or canopy of some kind, with which to 
shield the infant's eyes from the sunlight 
and glare. The lining of such protec- 
tion should be of some green fabric, 
which should be renewed as soon as it 
has faded to a pale shade. It is better 
that a baby should not wear a veil. In the 
first place, they are more or less injurious 
to the eyes. If worn for protection from 
the cold they are worse than useless, as 
they soon become moist from the breath. 
This moisture, coming in constant contact 
with the baby's tender skin, irritates and 
chafes it, and in cold days this moisture 
on the veil freezes, making it still more 
uncomfortable for the child. If the day 
is so cold or the wind so violent as to make 
a veil absolutely necessary, it is not a day 
suitable for the baby to go out. 

23 



CHAPTER IH 

THE NURSERY: ITS FURNISHINGS— 
THE NURSE 

A S the nursery is the room where the 
■^^ baby spends most of its time when 
in the house, and where it sleeps at night, 
it is well worth considering carefully what 
kind of a room this should be. Any room, 
or the room least likely to be of use in 
the house, is not the room for the baby. 
The place in the house for this room 
ought to be selected with great care. In 
the first place, it should be where the sun 
shines the greater part of the day, a south- 
ern exposure if possible, an airy room, 
and never on the first floor, which is sure 
to be more or less damp. One of the up- 
per stories of the house is best ; in a city 
house, the higher up the better, as there 
the sun lingers longest and the air is sure 
to be purer. The room should have at least 

24 



THE NURSERY-THE NURSE 

two good-sized windows. To insure pure 
air, in warm weather both windows should 
be kept open ; in moderate weather at least 
one window should have a sash lowered; 
in very cold weather it need only be lowered 
for an inch or two, according to the temper- 




WINDOW-BOARD 



ature out of doors ; also that of the nursery. 
If the weather be extremely windy, and even 
a slight opening of the sash seems inadvis- 
able, it would be well to use a window-board 
to secure good ventilation; this is simply a 

25 



THE BABY 

plain board, the width of the sash and a 
few inches high. By fitting this in the win- 
dow, and closing the sash on it firmly, 
a space is left in the middle of the win- 
dow where the sashes overlap, and con- 
siderable fresh air can enter the room 
through this space, leaving little danger 
of draught. This method of ventilation is 
greatly enhanced if there be an open fire- 
place in the room. Every nursery should, 
if possible, have an open fireplace in 
it, as it is a great factor in assisting 
in a free circulation of air. Next to the 
open fire comes the Franklin stove. Oil, 
gas, or the old-fashioned air-tight stoves 
for burning wood should never be used, as 
they not only throw off poisonous gases, but 
exhaust and consume the oxygen in the air. 
Not only should the purity of the air in the 
nursery be considered, but the temperature 
as well ; these are two points to which every 
mother and nurse should pay strict atten- 
tion. The great tendency is to have our 
houses too warm, and especially the nur- 
sery. The temperature of that room should 
never be allowed to go above 70 °, and this 
only for a very young infant; after the first 

26 



THE NURSERY — THE NURSE 

month 68°, but only for the day time; at 
night it may be several degrees lower. It 
is also important that the nursery be kept 
at as uniform a temperature as possible. It 
would be safer to keep the room at an even 
temperature of 65 , or even less, than to 
have it cool one moment and hot the next. 
Children brought up in overheated, poorly 
ventilated nurseries are usually puny, pale, 
and delicate, over - sensitive to cold and 
sudden changes, easily contracting pul- 
monary diseases — in fact, taking cold on 
slight provocation. Both the circulation 
and digestion of the child are affected 
under these conditions. It will be found 
that if at night the air in the nursery be 
kept cool and fresh, the child will sleep 
more soundly, and will not be troubled with 
restlessness, as will surely be the case if the 
room is hot and close. 

However, be cautious in one thing. In 
securing your fresh air, whether during the 
day or at night, take care that the baby is 
never placed in a direct draught; do not, 
with the baby in your lap, sit before an 
open window or door, or have his chair 
or bed in such position; a draught can 

27 



THE BABY 

often be felt in windy weather between 
window or door and open fireplace; if a 
draught is felt, protect the baby by placing 
a screen about the chair or bed. Every 
nursery should be provided with a screen. 
A simple, practical one may be made of an 




SCREEN 



ordinary, small-sized clothes-horse, a small 
brass rod or tape running across the top 
and bottom, on which is stretched a curtain 
made of white cambric. Two sets of screen- 
curtains should be made, in order that they 
may be changed and washed occasionally. 
Often, in the summer, it will be found 

28 



THE NURSERY — THE NURSE 

that the crib will need some slight protec- 
tion from draughts; this can be secured by 
hemming strips of white cambric, and se- 
curing these by tapes around the upper 
part of the crib. It will be well to know, 
also to remember, that the temperature of 
the room where your head is when standing 
is not the temperature of where the child's 
bed or chair is, but is many degrees warmer; 
consequently it is always best to hang the 
thermometer low — at about the height 
where the baby's head is. In view of the 
cooler atmosphere of the nursery at night, 
when it is necessary to change the baby's 
napkin during that time do not unneces- 
sarily expose him. A number of diapers 
can be folded ready for use, and placed under 
cover near the hot-water bag at the foot of 
the bed. With very little practice on the part 
of the mother or nurse a change can be made 
under the bed - clothes, and the wet diaper 
replaced by a warm, dry one, without expos- 
ing the infant in the slightest degree to the 
cold. Two changes at night will be found 
to be all that is necessary under ordinary 
circumstances. 

An objection which many mothers make 

29 



THE BABY 

to having the nursery cool at night is that 
an older child will kick off the covering, and 
in this way catch cold. This difficulty may 
be overcome in several ways. One can pin 
down the blankets with strong safety pins 
which come for that purpose. There are, 
also, several contrivances sold to fasten 
down the bed-clothes; but perhaps the best 
and surest way is to take a crib blanket and 
make a bag by sewing up the sides. Turn 
down a hem at the top and run a draw-string 
through it; place the child in this, fasten it 
securely under the arms, and he can turn 
and twist and kick to his heart's content 
without danger of exposure. Be sure, 
however, to have this blanket-bag large 
enough to allow free movements of the legs, 
and arrange it so that no bunch of gathers 
will be in the back for the child to lie on. 
This bag is only practicable for children 
who are old enough not to wet the bed at 
night, and should not be used in warm 
weather. If shoulders and arms are ex- 
posed, a light flannel sack may be worn. 

It has been suggested in the preceding 
chapter that the air in the nursery be 
changed every time the baby leaves it; this 

30 



THE NURSERY — THE NURSE 

excellent plan should be closely adhered to. 
Open the sashes a few inches, if only for a 
short time, as a little fresh air is better than 
none at all; but a great deal is much bet- 
ter. 

Let the furnishings of the nursery be 
selected with intelligence and care. They 
should be extremely simple; at the same 
time, the room should be cosey and cheerful. 
Sanitation and cleanliness should be one 
of the first considerations. Running water, 
wash - basins, plumbing, or any apparatus 
for cooking should not be allowed in the 
nursery; all this should be arranged in an 
adjoining room. Napkins should not be 
hung there to dry; in fact, nothing should 
be kept there which would tend to taint the 
air in the slightest degree. Sour clothes or 
soiled napkins, on being taken from the 
child, should not be allowed to stand, but 
should be removed from the room at once. 
If necessary to put the napkin down for 
a moment, do not place it on chair or floor 
for even a very little while; if you do, in 
a short time it will result in the nursery 
acquiring a bad odor, and one not easily 
gotten rid of. At such times always have a 

31 



THE BABY 

small agate basin to use as a receptacle, or 
good-sized squares of stout paper can be 
kept at hand and utilized for this purpose. 

Heavy drapery, portieres which keep out 
the light and air, upholstered furniture, are 
not suitable for a nursery. If drapery is to 
be used at all, it should be of some light ma- 
terial which can be washed. The furniture, 
too, should be of a kind that water cannot 
hurt. The little chairs may be provided 
with cushions for back and seat. These 
should be detachable, and covered with 
slips that can be removed and washed when 
necessary, and the cushions themselves 
ought to be brushed every day. Bedsteads 
or cribs made of brass or of iron finished 
with enamel paint are the best, the latter 
being the most practical for ordinary use, as 
it may be dusted with a damp cloth each 
day without injury, and is very easily kept 
clean. Wooden cribs, or those made of 
reed or rattan, are not desirable, as it is 
impossible to keep them perfectly clean in 
spite of any amount of good care. Every 
curl and twist of the material of which 
they are made forms creases where dust 
may lodge, and remember that it is in these 

32 



THE NURSERY — THE NURSE 

particles of dust that germs of disease find 
a resting-place. It is well to keep both 
out of the nursery, if possible. The mat- 
tress should be a wov en-wire one. Those 
made of hair,^j$$on, excelsior/ or Juiy of 
the other matermfe^^^^H^tf(^ffiis pur- 
pose, ought not to be useS^^infants. It 
is impossible to keep such a mattress in a 
satisfactory, clean, and sanitary condition. 
The proper thing to use is a heavy gray 
blanket, folded several times to the size of 
the crib. This is placed on the wire mat- 
tress, and on it a large square of nursery- 
cloth ; this is to keep out cold, also to protect 
the blanket. Over this put the sheet, then 
a soft -quilted cotton pad for the child to 
lie on. This arrangement makes a bed 
that can be kept absolutely clean and sani- 
tary ; it can be aired every day and all day 
if necessary; it can be washed and fumi- 
gated — in fact, it is a thoroughly clean, 
comfortable, and ideal bed. 

The walls of the nursery should be of 
hard finish, either plain or painted. Pa- 
pered walls are not so healthy, as the paper 
absorbs moisture, retains odors, and the dust 
clings to it. Neither can it be washed, while 
1 33 



THE BABY 

a plain or painted wall may be scrubbed 
if necessary. Once a week it is desirable 
to have the nursery walls rubbed down 
with a damp cloth. An old, soft piece of 
cotton or linen cloth, fastened securely over 
a new broom, answers this purpose very 
well, although a felt brush is manufactured 
for this purpose. The nursery floor should 
not be covered with matting or carpet, for, 
despite good care, at best these can be only 
dirty and unsanitary. They cannot be 
washed, and when swept a good portion of 
the dust flies about the room, and finally 
settles on walls and furniture, while much 
sifts through the fibre, to accumulate and 
remain on the floor beneath. The floor 
should be of hard wood polished, or ordinary 
wood painted or covered with linoleum. 
These floors, with little care, may be kept 
absolutely clean; all the dust lies on the 
surface and is easily removed. If the 
floor is swept with a hair floor-brush — or, as 
a substitute, cover an ordinary broom with 
a bag made of outing flannel, or some 
soft, stout material — very little dust will 
arise from the sweeping process. After 
that the floor should be wiped over with a 

34 



THE NURSERY — THE NURSE 

damp cloth. Rugs may be placed on the 
floor, but have them small and light enough 
to be easily handled, that they may be 
taken up and aired every day, if it is nothing 
more than to give them a shaking from the 
window. It is a bad plan to hang many 
pictures on the wall. Have only a few in 
very simple frames, without carving, fili- 
gree, or gilt. Most children show a de- 
cided preference for pictures of domestic 
animals — cats, dogs, etc. Every orna- 
ment and piece of furniture in the nursery 
should be such that it can easily be kept 
clean without injuring it. Dusting should 
never be done with a feather -duster or 
dry cloth. This only flirts the dust from 
one place to another, without really get- 
ting rid of it. The best duster is one 
made of cheese-cloth. Wring this out 
as dry as possible from a basin of cold 
water ; it will do no harm if a little carbolic 
acid, ammonia, or mild disinfectant is put 
in the water. The damp cloth removes 
and holds the particles of dust, while the 
disinfectant freshens the air in the room. 
In dusting, do not neglect any little place 
where dust finds a lodgment, especially 7 

35 



THE BABY 

behind pictures, the base-work behind fur- 
niture, rounds of chairs, etc. As far as 
spotlessriess is concerned, let the nursery 
be the show-place in your house. Have 
nothing superfluous in it — crib, nurse's bed, 
a little rocker for the child if old enough to 
use it, one low rocker and one plain chair for 
the nurse, low table and chiffonier or bureau 
for the baby's clothes only. It is well to 
state here that the nurse's clothing, toilet 
articles, or personal belongings ought not 
to be kept in the nursery; a separate place 
should be provided for them. Have the 
drawers where the infant's clothing is 
kept dusted out occasionally. Also see 
that all clothing is well aired before it is 
put away. The garments should be neat- 
ly folded and put away in order, reserving 
a drawer for small articles, such as bands, 
shirts, and socks. Put each in separate piles, 
not laid in promiscuously. Have another 
drawer for skirts and dresses, and so on. 
Always know where you can put your 
hand on each separate piece at any moment. 
The baby's basket is another accessory 
which demands attention. It is too often 
an elaborate affair of laces and ribbons, 

36 



THE NURSERY — THE NURSE 

which, from constant use, soon becomes 
soiled and bedraggled. The trimmings 
should be made of washable material. Leave 
off the frills. It may be simply constructed 
and still be dainty. Have it refreshed often 
enough never to look mussed up, and do 
not keep it too full. It is not intended to 
be a catch-all for everything that belongs 
to the baby. Keep in it only the things 
necessary for each day's toilet. After the 
morning bath arrange it for the night, and 
after the baby has been put to bed see that 
everything is ready for the morning toilet. 

In connection with the nursery, it is fitting 
to touch for a moment on the subject of 
the nursery-maid. She should be a person 
preferably between the ages of twenty-five 
and thirty-five, with clear skin, good teeth, 
and a healthy and sound body. A nervous 
woman should never care for an infant. It 
is the mother's duty to look after and insist 
upon the personal cleanliness of the wom- 
an who takes care of her child, to know 
that her under-clothing is clean, to manage 
that time be given the nurse for frequent 
or daily baths, and to have the conven- 
iences for such provided for her. While in 

37 



THE BABY 

the nursery or house, insist upon her wear- 
ing wash dresses, ample white aprons, white 
collars and cuffs, and a cap to protect her 
hair from dust. Require absolute cleanli- 
ness of person and dress, and do not allow 
her, especially when handling the baby or 
in the nursery, to wear woollen dresses, 
or a dress which she wears to her home, to 
the house of her friends, or in the street- 
cars. 

There are many other things to be con- 
sidered in a nurse, such as character, dis- 
position, ability, etc., but among other car- 
dinal virtues the above are qualifications 
absolutely necessary. 



CHAPTER IV 
THE BABY'S BATH AND CLOTHING 

AN important part of the baby's care 
and training is the bath. The clean- 
liness which it imparts, the massage of 
muscles and skin which it makes neces- 
sary, the healthful glow and reaction which 
follow, each has its own little share in 
making the healthy child. Do not be sat- 
isfied with or think that a little sponging 
once or twice a day is all the bath a 
baby needs. The baby cannot be properly 
washed or made clean in this manner, as it 
is difficult to properly rinse all the soap 
from the skin ; then, again, the child is ex- 
posed to the air too long when bathed in 
this way. Put the baby in the tub once a 
day — a good -sized tub, which will hold 
enough water to allow him to kick and 
splash and to remove all traces of soap 
from the skin. A baby should really have 

39 



THE BABY 

two baths a day, a full - tub bath in the 
morning and a sponge bath at night before 
being put to bed ; no soap need be used with 
this evening bath, but a very little borax 
may be added to the water. Do not give a 
bath immediately after a meal ; it should be 
given one hour before or one hour after feed- 
ing. The temperature of the room should be 
at 70 for an infant, and not less than 
68° for an older child. In moving about 
the room making necessary preparations 
for the bath one naturally becomes more 
or less heated, consequently do not judge 
the temperature of the room by your own 
feelings; rely solely on the thermometer, 
and hang it on a level with the bath-tub. 
It is almost always best to have a fire be- 
fore which to bathe the baby ; it is advisa- 
ble, sometimes, even in summer when there 
is much dampness. Before sitting down to 
the work of giving the bath, see that every 
thing is in readiness, and do not have to 
get up or call for things after the bath is 
once commenced. The basket should stand 
near at hand containing safety-pins, wood- 
en toothpicks, threaded needles for sewing 
bands, scissors, absorbent cotton or soft 

40 



THE BABY'S BATH AND CLOTHING 

lint cut in small squares, dusting-powder, 
etc. A good nurse will see that her 
basket is always well stocked. On a low 
table alongside of her she will have soap, 
bath thermometer, wash-cloth, small cup con- 
taining boiled water or boric-acid solution 




RUBBER BATH-TUB 



for cleansing eyes and mouth, a basin of 
water 98 for rinsing wash - cloth, also 
pitcher of very hot water for use in case the 
water in the tub gets too cool before it is 
time to put the baby in it. One full set of 

4 1 



THE BABY 

clothing may be kept in the basket, and just 
before the bath it should be taken out and 
hung over a small clothes-rack or frame, in 
front of the fire, to air and warm. Never put 
a cold garment on an infant. Place the cloth- 
ing over the frame in the order it is to go on 
the baby : first, dress ; on top of this the pet- 
ticoats ; then shirt, band, and diaper ; the lit- 




FLANNEL APRON 



tie socks may be warming on the hearth. The 
person who is to give the bath should wear 

42 



THE BABY'S BATH AND CLOTHING 

a large flannel apron, and, pinned to the belt 
of this, a large, soft towel. A rubber bath-tub 
is best and most convenient; if you have 
not one of these use the baby's oblong bath- 




v/ 

BATH-TUB AN! TABLB 



tub on a low table. Be generous when you 
fill the tub ; do not spare the water. The 
proper temperature of a bath is between 98 
and ioo°, neither over nor under, as this 
is the normal temperature of the body. 
The water should be as near this as possi- 
ble, and there will be no danger of either 
chilling or overheating the blood. Here, 
again, rely upon the thermometer ; do not 
attempt to test the water by your hand ; what 
may seem only fairly warm to the hand may 
be hot enough to scald a little baby's tender 

43 



THE BABY 




flesh. If for any reason a bath thermometer 
is not at hand, the elbow is a fair test; do 
not have the water any warmer 
than the elbow can comfort- 
ably stand. 

Now, everything being in 
readiness, take the baby on 
your lap, having turned the 
towel to one side so that he 
lies on the flannel apron. Han- 
dle him as little as possible, 
rolling him when a change of 
position is necessary, but do 
not lift him, as pressing the 
fingers on stomach and abdo- 
men, where the delicate organs 
lie, is uncomfortable to the child 
and often injurious. 

In removing a garment with 
sleeves, especially if it has a 
small opening, let the baby lie 
on his back; gradually and 
_# gently work the part which is 
CJI|| under the child up as far as 
possible until it lies in a roll 
under the neck; the arms can 
then easily be taken from the 

44 



BATH 

THERMOMETER 



THE BABY'S BATH AND CLOTHING 

sleeves without bending or twisting, and 
the garment slipped over the head with- 
out any discomfort to the child. When 
the clothing is all removed with the ex- 
ception of the diaper, which is unfastened 
but left under the baby, cover him with 
the flannel apron, tucking one corner well 
under the shoulder nearest you. Use 
the water in the basin for washing. First 
bathe the face with clear water ; then, 
soaping the wash-cloth, lightly wash the 
head, ears, and neck; rinse these with the 
water from the basin, and then dry, so that 
there will be no danger of his catching cold. 
This done, soap the wash-cloth well; one 
soaping will usually answer for the entire 
body. Still keeping the child well covered, 
place your hand under the apron and wash 
the chest in front, being sure to get into the 
folds under the arm and in the groin ; arms 
and legs are uncovered one at a time and 
washed, and quickly put back under cover, 
especial care being taken to wash well be- 
tween the fingers and toes and in the palms 
of the hands. Now roll the baby towards 
you and wash the back. With a little 
practice the whole body can be well washed 

45 



THE BABY 

in a few minutes without exposure to the 
child. 

Next test the water in the tub with the 
bath thermometer; if it has cooled, add hot 
water from the pitcher until it reaches the 
proper degree. 

Then place the left hand under the baby's 
back and let the body rest on your palm; 
extend the three middle fingers down the 
back, with thumb and little finger stretched 
from shoulder to shoulder; this will form a 
support for the entire body. Let the head rest 
on your wrist and grasp the feet with your 
right hand, and lift the baby into the tub in 
a sitting position, still supporting him with 
your left hand; with the right hand dash 
the water over head and chest and rub the 
baby well. The child will enjoy it. When 
he has been in a few moments take him 
from the tub, your hand still under the 
back, holding his feet in the same manner 
as when he was put in. The towel will 
now have fallen down in front. Wrap him 
up in that and the flannel apron, dry the 
head first, then gently pat him all over, 
rolling from side to side; this will be suf- 
ficient to dry the body, except in the creases 

46 



THE BABY'S BATH AND CLOTHING 

• 

and folds, where he must be gently dried 
later. Never rub a baby's skin roughly 
with a towel ; it is very tender, and a gentle 
patting will dry him just as well. Now dust a 
little powder, not all over the baby, only in 
the folds and where there is the slightest 
danger of chafing; you are then ready to 
put on diaper, next band, socks, shirt, 
petticoat, and dress. 

No clothing should be drawn on over the 
baby's head. Run your hand through the 
garment, catch hold of the feet, slightly ele- 
vate the body, and draw the clothes on from 
the feet up; in this way they go on with 
much less discomfort and disturbance to the 
infant. 

When the baby is bathed and dressed, 
turn your attention to the eyes, mouth, and 
nose; from the cup partly filled with warm 
water, or boric acid solution, wet a little 
piece of absorbent cotton or linen, open the 
eye wide with thumb and forefinger, and 
let a drop of the water fall in. Use a sepa- 
rate piece of cotton for each eye, for the rea- 
son that if one eye is a little sore or has pus 
in it the infection will not be carried to the 
well eye, as is often the case when but one 

47 



THE BABY 

piece of cotton is used. Wrap another small 
piece of cotton or linen around the little 
finger, dip it into the water, and gently 
swab inside the mouth and about the gums ; 
be very careful not to use much force ; 
simply sopping it is enough to make 
clean. Babies' mouths are often 
made sore by too vigorous cleansing. 
Now take a wooden toothpick and 
around the end of it twist a tiny 
piece of absorbent cotton; use this 
to cleanse the nose ; go into the nos- 
trils very carefully and only a short 
distance. It is most important that 
the nose should be properly cleansed 
each morning. When this is neg- 
lected the nostrils become clogged, 
and a child suffers much discomfort. 
It interferes with his breathing, and 
also seriously interferes with his 
nursing. The toothpick and cotton 
are also useful in getting into the 
folds of the ear, where the soap is 
apt to lodge and dry. But be care- 
ful to use only a small bit of cotton, and have 
it wrapped well all around the end of the 
toothpick, so as to cover the point and keep 

48 



WOODEN 
TOOTH- 
PICK 









: 

■• •■■' ■ ' " ■ .. 

*/ 1» Jill 


m 






Wrmm 


-*, 






"ft\* 


W^^BR 




V 


- ^^HH 



PLACING THE BABY IN THE TUB 



THE BABY'S BATH AND CLOTHING 

it from injuring the child. The entire bath 
from beginning to end, until the toilet is 
complete, can easily be given in half an 
hour; during this time the child has not 
been exposed except for the few moments 
he is in the warm water, and if water and 
nursery are both of the right temperature 
there is no danger of his catching cold. 

The only conditions under which the bath 
should be omitted are in cases of sickness 
or some skin trouble. Children suffering 
from eczema should not be put into the tub. 
Neither should soap be used on a child 
whose body is covered with prickly heat; 
in this latter case a cupful of brail tied in a 
gauze bag should be put into the water and 
kept there until the water has a milky ap- 
pearance. It takes the place of soap. 

In summer the warm sponge bath at 
night is especially quieting and conducive 
to sleep. If the child is at all troubled with 
heat rash, or urticaria (hives), a scant tea- 
spoonful of soda bicarbonate or a very 
small bit of starch added to the water — just 
enough to give it a slightly cloudy appear- 
ance — has a particularly soothing effect. 

Just a suggestion as to soap and the 
4 49 



THE BABY 

use of sponges. Use only the very best 
and finest soap made; it does not pay to 
use anything else. A baby's skin is tender 
and soft; a harsh soap will injure it. A 
pure castile soap is very good, but the strong, 
soapy odor it leaves is often an objection. 
A fine French soap is best, and not extrav- 
agant, as one cake, if used only for the 
baby, will last for months. 

As for sponges, I can only say, Don't I 
No matter how fine or how good they are, 
and no matter how much care is used in 
cleaning them, they are still dirty. Every 
pore of the sponge is a cell for all sorts of 
refuse and germs. The fine scales and 
the oil from the skin cannot be properly 
eliminated from them, and any attempt at 
washing only rubs these scales and dirt 
farther into the heart of the sponge, where 
they lodge and decay. Nothing but boiling 
can ever really clean a sponge, and boil- 
ing would ruin it, which would be the best 
thing that could happen. 

Now that the baby has had his bath, 
let us consider his clothing. Most of our 
American babies wear entirely too much 
clothing — clothing that is too heavy, and 

50 



THE BABY'S BATH AND CLOTHING 

from which they do not get a corresponding 
amount of warmth as compared with the 
weight they carry. Again, many mothers, 
in their desire for elegance, lose sight of 
what is most sensible and healthy. The 
material for children's undergarments is a 
matter for serious thought. A child is just 
as likely to suffer from being dressed too 
warmly as from the other extreme — namely, 
being insufficiently clad. 

In selecting the baby's clothes they 
should be chosen with reference to warmth, 
lightness in weight, and absorbing proper- 
ties. Silk is most delightful to the sense 
of touch, and is cool for summer, but it does 
not absorb moisture; consequently, if the 
baby perspires much, the shirt lies damp and 
cold next to the skin, and it takes only a 
very slight draught or wind to chill the little 
body, usually at the expense of some of its 
vitality. There is not enough heat-giving 
property in silk to make it desirable for 
cold weather. The same may be said of 
linen, only more strongly ; consequently we 
may as well strike it from the list of fab- 
rics fit for an infant's underwear. Soft, thin, 
cotton undergarments are slightly better 

51 



THE BABY 

for summer use than either silk or linen, be- 
cause in a degree they are more absorbent. 
For cold weather, however, cotton is not 
good, and should not be worn by infants and 
young children. It is too thick and clumsy, 
and does not impart the warmth that their 
small bodies require. One invariably finds 
cold hands and feet, even though the infant 
lies enveloped in the heaviest and thickest 
cotton garments made. In such cases the 
hot -water bottle is always a necessary 
requisite for sustaining heat. Wool is by 
far the best material used for infants. It 
has a certain life and warmth which the 
others do not possess ; it also absorbs moist- 
ure as the others do not. Within the chest 
and abdominal walls lie the vital organs, 
and they need as careful protection in sum- 
mer as in winter. The stomach and intes- 
tines require just as much heat to aid in the 
work of digestion in one season as another, 
and if woollen abdominal bands were worn 
more commonly during the heated terms 
there would be far less trouble from summer 
complaint, inflammation of the bowels, and 
all intestinal derangements. Woollen un- 
dergarments should be worn all the year 

52 



THE BABY'S BATH AND CLOTHING 

round, and the quality graded according to 
the seasons — medium weight for winter, 
light for spring, and the thinnest obtainable 
for summer. The heaviest weight never 
should be used ; in fact, it is dangerous for 
infants to wear it, as during our most severe 
seasons there are many days when the at- 
mosphere is mild, not to say warm. Very 
thick garments at such times are too heating ; 
they become oppressive, and tend to weaken 
the child and make him very sensitive to 
changes. Then, again, if the nursery is 
kept at a uniform temperature, say 68 or 70 
degrees, which is only a few degrees 
below summer heat, why the need of such 
warm clothing? It will only cause the 
child to perspire, and then, when taken out 
for an airing into the cold air, the body 
being overheated and the underclothing 
damp, there is most certainly grave danger 
of his contracting lung trouble. 

By wearing underclothing of medium 
thickness this danger is averted, as the child 
is not nearly so liable to become overheated 
while in the house. Then, on very cold days, 
an extra sacque or outside wrap may always 
be added, to maintain the extra warmth 

53 



THE BABY 

desired. In addition to the shirt, a child 
should always wear an abdominal band 
all the year round. For a very young infant 
the band is made of a simple strip torn from 
a piece of flannel ; the edges should not be 
hemmed, but be perfectly plain or pinked. 
This band is rolled about the abdomen and 



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ABDOMINAL BAND 



fastened by sewing. Do not use pins about 
an infant's clothes. The supposed object 
of the rolled band is to prevent umbilical 
hernia or rupture. It is rather doubtful, 
however, if it is particularly useful in ac- 
complishing this end. After the first six 
or eight weeks this can be replaced by the 
ribbed or knitted band, which ought to be 
worn at least until the child reaches its 
third year ; longer if the child is subject to 
intestinal weakness or disorders. 

54 



THE BABY'S BATH AND CLOTHING 



m 












• - - " : -... ; .- 



As there is much difficulty experienced jlli 
obtaining very thin underwear made of wool, 
a mixture of silk and wool or cotton and 
wool is recommended for 
summer use. Even these 
are not easy to find in the 
shops in this country. In 
England it is more com- 
mon, as there it is manu- 
factured especially for the 
East Indian trade. When 
the gauze weight is not 
obtainable, I would advise 
leaving on the shirt en- : '^m 

tirely during the warm | Wm 

weather and letting the 1 
child wear only the band 
of medium weight. It 
can be found quite long, 
with little straps at the 
shoulders to keep it in place. With this 
band both chest and abdomen are well 
protected, and if a sudden coolness arises 
which makes it seem advisable to protect 
the arms, a light sacque can be worn. The 
flannel petticoats should be of two grades, 
medium for cold weather, light weight for 

55 






THE BAND 



THE BABY 

summer. The former should be entirely of 
flannel, waist-band and skirt of one weight ; 
for summer the band may be made of fine 
cambric. Several flannel sacques of varying 
degrees of thickness, two or three square 
flannel blankets, and one or more down 
comfortables should be pafrt of the baby's 
outfit. There is more warmth in one thin 
comfortable than in two double woollen 
blankets, which makes it a most desirable 
covering at night for infants. Lightness 
combining warmth should be carefully con- 
sidered in the baby's wardrobe. The baby's 
clothes should never be worn too tight, 
neither should they be too loose. Tight- 
fitting garments should never for a mo- 
ment be tolerated. Especially may this be 
said of the band. If this is bound too 
snugly about the child, the organs are 
crowded from the places where nature 
has placed them and intends them to 
lie. Tight binding not only impedes the 
action of the lungs, but is often the cause 
of vomiting in young infants. On the 
other hand, loose, flowing garments, while 
perhaps not dangerous, are most uncom- 
fortable, They do not cling close enough 

56 



THE BABY'S BATH AND CLOTHING 

to the body to give sufficient warmth. It is 
almost impossible to keep loose clothes 
smooth; they work up and wind about 
the little body in a most disagreeable way, 
especially if the mother is young and inex- 
perienced in handling babies, or the nurse 
is awkward ; and the poor baby lies much 
of the time in a bed of wrinkles, which crease 
and seam the tender flesh. Moderately 
snug -fitting clothes are the perfect ones 
for infants and children, garments which 
will admit of easy movements and free 
circulation, and at the same time afford 
a moderate amount of support to the chest 
and abdominal muscles. I repeat that pins 
should never be used to fasten a baby's 
clothing. The band, which should be just 
snug enough not to wrinkle, should be fast- 
ened with needle and thread; roll it first, 
then start to put it on at about the cen- 
tre of the abdomen ; hold it firmly there by 
placing the left hand flat on it, and with 
the right hand roll it about the body. It 
should end and be fastened under the arm ; 
if it ends in the back the child will have 
an uncomfortable seam to lie on. The 
shirt is put on next. Most woollen shirts 

57 



THE BABY 

are made with a little piece attached to 
the bottom in front, to which the diaper 
is pinned. This prevents the shirt from 
working up about the body, also keeps 
the diaper from slipping down. If the 
shirt has not this little attachment, a piece 
of broad tape may be sewed on to answer 
this purpose ; it is not a bad idea to have 
a piece both back and front. The barrow- 
coat, or petticoat, should be fastened in the 
same manner as the band, or tied with tapes 
instead, if need be; it should also have 
a shoulder-strap of soft silk braid about a 
half to three-quarters of an inch wide. 

The baby's dress is prettiest when made 
of soft, white material, such as nainsook or 
dimity, without trimming, unless it be a lit- 
tle lace or fine embroidery at neck and 
wrists. A few fine tucks may be made, or 
a little hemstitching ; but embroidery, ruf- 
fles, etc., are out of place for this very 
young and innocent morsel of humanity. 
Do not make the clothes too long; to 
barely cover the feet is sufficient. All that 
hangs below the feet is only an additional 
weight for the baby to carry, and will drag 
on the little feet and legs. There is no 

58 



THE BABY'S BATH AND CLOTHING 

danger of these members suffering from 
the cold if properly clad in long stockings 
and bootees, the same as you would pro- 
vide for an older child. Long clothes in- 
terfere with the free movements of the legs. 
If you want the muscles of the lower ex- 
tremities to develop and grow strong, you 
must allow them to be active, which they 
cannot be if held down by a quantity of 
heavy clothing. 

" Shall my child wear stockings or socks?" 
is a question which is very often asked. 
Well, while no harm may come from wear- 
ing socks in warm weather, and the little, 
chubby, bare legs are very pretty to look 
at, in a climate as changeable as ours the 
wearing of socks is attended with some 
risk. In cold weather it is positively un- 
safe. The extremities should be kept warm, 
especially the feet; there is no doubt that 
many colds are contracted from this un- 
necessary exposure of the child's legs. 
I would advise to set aside looks, consider 
the comfort and health of the child, and 
cover his little legs with good, long stock- 
ings. 

As for shoes, clothe the feet of your little 

59 



THE BABY 

one first with warm, knitted bootees, later 
replace these with soft kid ones, and, 
when old enough to walk, let him wear 
shoes of fine kid or leather, with a soft, 
flexible sole and no heel. Have the shoes 
broad enough to give all the toes full play. 
Carefully avoid anything that borders on 
a narrow or pointed toe, as it not only 
crowds the little toes into a small, uncom- 
fortable space, but is too often the source 
of painful corns. Be sure, also, that the 
shoes are quite long enough; it is better 
to have the shoe a whole inch too long 
than to have it a sixteenth part of an inch 
too short. Many adults are great suffer- 
ers to-day, having incurable deformities of 
the feet caused by wearing, when children, 
shoes too short for them. 

The baby's diapers may be of cotton or 
linen, the former being slightly preferable, 
as they are somewhat warmer and more 
absorbent. A fine cotton-flannel diaper is 
most excellent for use in winter. It is well 
in cold weather to fold a square of the cot- 
ton-flannel once in the middle, not triangu- 
larly, place in the fold a small square of 
thin mackintosh cloth or prepared fabric 

60 



THE BABY'S BATH AND CLOTHING 

called imperveaux, and fasten this about 
the baby's thighs over the diaper. This 
need only be worn when the baby goes 
out, and will be found to be effectual in 
keeping petticoats and clothing dry; it is 
also useful at night, serving the same 
purpose. The protective square should be 




COTTON-FLANNEL DIAPER 



small — only large enough to reach from 
thigh to thigh. 

In making and procuring a wardrobe 
for her baby, let the mother's first and 
only thought throughout be his health 
and comfort. She should also study sim- 
plicity. Simple and comfortable garments 
need not necessarily be ugly ; prettiness and 

61 



THE BABY 

daintiness need never be sacrificed ; and for 
those in humble circumstances, it might be 
added, neither does material matter, whether 
it be fine or coarse, so long as it is always 
clean and spotless. 



CHAPTER V 

SLEEP AND AMUSEMENT 

PVERY healthy child should be a good 
*-* sleeper. If he is not, there is some- 
thing decidedly wrong in that particular in- 
fant. Most probably he has been given a 
wrong start in life. For the first few days of 
his existence a new-born babe ought to sleep 
most of the time. As the child grows older 
the sleeping hours during the day gradually 
diminish; the hours of night sleep should, 
however, remain the same — about twelve 
hours. By the time the child reaches the 
age of one year, from two to three hours' 
sleep in the daytime is all he will indulge 
in, usually in two naps. As he grows 
still older the sleep will dwindle to one 
nap in the middle of the day, which habit 
should be kept up, if possible, until the 
child is at least four or five years old. 
It is wisest to start with the baby on 

63 



THE BABY 

his very first day and train him in regular 
sleeping habits. Habit and regular feeding 
hours go hand- in-hand in producing proper 
sleep and health. Much sleeplessness in 
babies is caused by indigestion. This does 
not always mean that the food is wrong, 
but very often that it is wrongly admin- 
istered — given to the baby at irregular 
intervals and in irregular quantities — 
thus causing pain and discomfort, which 
interferes greatly with healthful sleep. 
Consequently, establish at once regular 
and systematic feedings. Do not omit 
or defer giving the baby his food at the 
regular hour because he happens to be 
asleep; wake him; it will not do the slight- 
est harm, and he will soon fall into the 
habit of waking when that time comes. 
A very young infant should be fed twice 
during the night; at the age of four or 
five months, not more than once — the 10 
P. M. feeding. Thus are good sleeping 
habits at night formed. Constant nursing 
or feeding at night is bad for the baby. 
He should never be allowed to sleep at the 
breast, or to have the bottle to suck when- 
ever he wants it. The sucking of the fin- 

6 4 




WRAPPED IN THE BATH BLANKET 



SLEEP AND AMUSEMENT 

gers, the so-called "mother's comfort/' 
supposed by some persons to quiet babies, 
or any other device is not needed to in- 
duce sleep in a healthy, well-trained infant. 
It is entirely unnecessary to coax sleep 
in any way; rocking, walking, singing, 
lying on the bed with the child, patting 
the bed or pillow, as many mothers say 
they have to do, and all other tricks are 
wrong and have a perceptible effect on 
the small infant's nerves. After the baby 
has been fed and made comfortable, place 
him in his crib, and do not fuss about 
him. He may not shut his eyes and go to 
sleep at once. What of it? He probably does 
not want to. He would rather look about 
him for a little while and make acquaintance 
with the objects in the room. He may even 
indulge in a cry. His lungs need a little 
exercise. Do not check these harmless 
amusements in which he indulges. Do not, 
either, the moment the baby is put down 
for his nap, think that every sound must 
be hushed. This is the time for the mother 
or nurse to perform many little neces- 
sary duties, not on tiptoe and with bated 
breath, but in a natural manner. The 

» 6 5 



THE BABY 

baby will from the beginning become accus- 
tomed to ordinary household sounds, con- 
versation in the same room, etc., without 
being in the slightest degree disturbed. It 
is the unusual or sudden sharp sound com- 
ing out of profound stillness which disturbs, 
whether the child be asleep or awake. At 
night there is no excuse whatever for wake- 
fulness if the mother is sensible, and early 
commences the forming of proper habits. 
Arrange, if possible, to have the evening 
nursing come at 7 P. M., or as near that 
hour as possible, but never later. Half an 
hour, or more if need be, before this time 
commence preparations for the night; see 
that everything which may be needed dur- 
ing the night is in readiness. Take off the 
baby's outside garments and bathe with 
warm water the face, neck, and chest, and 
such parts of the body as can be conven- 
iently got at without stripping the child. 
Then put on the night wrapper. Exam- 
ine all the clothing well. See that it is 
comfortable and smooth, and not a wrinkle 
for the baby to lie on and grow restless; 
that the bands are comfortably loose, and 
that there are no pins anywhere pressing into 

66 



SLEEP AND AMUSEMENT 

or irritating the tender flesh. The hands 
and feet must be warm, and the diaper 
dry. Now put the baby in its crib, and in 
cold weather be sure to slightly warm the 
sheets before he is ready. Attend to the 
ventilation; turn down the light; give the 
baby his bottle, and stand by to see that 
he does not lose it or go to sleep before it is 
half finished. When he has emptied it, take 
the bottle from him and leave the room. 
If the child is a nursing baby, nurse him 
before putting him to bed; there may be a 
little struggle or crying for one night, pos- 
sibly two, but not longer. If at any time 
the baby wakes and cries, do not hurry to 
him at once; wait a few moments and see if 
he will not fall asleep again. But if the cry- 
ing persists, go to the nursery and look the 
baby over carefully for any signs of dis- 
comfort. He may be wet ; his hands and 
feet may be cold. If, after a careful ex- 
amination, no cause for the crying can 
be found, change his position by turning 
him; then leave him and let him cry it 
out. The struggle, as has been said, will 
be a short one. In a night or two the habit 
is formed, and the chances are that there 

6 7 



THE BABY 

will never be another one of this kind. It 
is much better to have it over at this early 
age than to wait until the child is older, 
as he is then more stubborn and his will is 
stronger. If you wait, it will be much 
harder for the child and for yourself. 

The following suggestions may be fol- 
lowed by the mother with perfect safety, 
and are important, if not absolutely requi- 
site for the well-being and health of her 
infant. A baby should never sleep with 
an older person, or, in fact, with any one, 
but should have a crib to himself. When the 
child is put to bed with the idea of sleep, 
darken the room and have it well ventilated 
and cool. Do not make preparations for 
retiring in the same room where the baby 
sleeps, neither turn up the light nor take 
the child from the bed to feed or change 
him; if you do, there is danger of his be- 
coming thoroughly awakened; both can 
be done in the bed with dim light and with 
very little disturbance to the child. 

Let the infant lie with his head low. For 
the first few weeks a folded pad or small 
blanket placed beneath the sheet at the head 
of the bed is all that is needed ; after this a 

68 



SLEEP AND AMUSEMENT 

flat hair pillow; feathers are rather apt to 
be heating. If baby is restless, or, maybe, 
slightly feverish from some slight disorder, 
a warm sponging of the entire body will 
usually quiet and soothe him ; but do not 
under such circumstances, or, in fact, for 
any reason, give soothing syrups or quiet- 
ing drugs ; they simply quiet for the time, 
and when the effect passes off leave the 
baby weaker and more excitable. Never 
give drugs without the advice of a physi- 
cian. 

The light once turned down and the child 
in bed, do not allow visitors in the nursery, 
no matter whether the child is sleeping or 
awake. Lastly, and very important, be 
most careful about exciting the little brain 
to too great mental activity during the 
wakeful hours of the day, especially the 
hours just before bedtime; excessive amuse- 
ment will excite the rapidly developing 
brain and cause wakeful hours. 

The new-born infant needs absolutely no 
amusement whatever. The brain is more 
carefully protected in its case of bone than 
any other organ in the whole body; this 
alone would naturally lead us to believe 

6 9 



THE BABY 

it the most delicate. Scientists and physi- 
cians tell us that the brain grows faster dur- 
ing the first year than at any other period. 
With these facts before us, why try to force 
this rapidly developing and sensitive organ 
faster than nature provides? For one year, 
at least, do not urge or overtax it. It is 
far more important that training should 
commence before amusement; the latter 
starts in such small and subtle ways that 
many a poor young mother is deep into it 
before she realizes it has had a beginning, 
or that such a small beginning could have 
such direful results. It is usually as fol- 
lows: There is a little cry, then the first 
act commences ; the infant is picked up and 
swayed to and fro several times. This has 
the desired effect, but at the same time the 
brain has been stimulated for a new desire, 
and the next time he cries he not only ex- 
pects what he was given before, but craves 
a little more, and he is going to scream 
until he gets it, so he usually gets what he 
wants at this tender age. It is not long 
before merely taking up does not satisfy 
him; this form of entertainment has lost 
its novelty for the over-stimulated brain; 

70 



SLEEP AND AMUSEMENT 

it craves something new and still more ex- 
citing. Rocking is then introduced by way 
of change, patting, dancing up and down, 
walking, talking, rattles, noisy, squeaking 
toys, anything that will keep the baby quiet, 
follow each other in rapid succession. By 
this time the little brain is so overworked 
that the poor baby is in a highly nervous 
state. Poor baby, has he no rights? In 
this case his only one seems to be the 
right to submit, and, at an early age, 
succumb to nervous prostration — a peev- 
ish, unhappy little thing. Surely no adult 
could stand a like amount of strain. If 
from the first the infant is left to supply 
his own amusement, you may be quite 
sure this state of affairs will never exist; 
he will be extremely moderate, and move 
no faster than the normal brain dictates. 
To eat, sleep, cry a little, and be let alone 
is all the new-born babe asks ; soon he will 
begin to see things and find amusement 
in looking about the room, or following 
moving objects with his eyes; after a while 
he will laugh and crow, discover that he 
has fingers and toes, and delight to play 
with them by the hour. He is never immod- 

71 



THE BABY 

erate in his little dissipations, never taxes 
his brain beyond its power of endurance; it 
is only when the adult steps in and urges 
him on that he goes beyond his powers. It 
is the adult who does not know when the 
limit of endurance is reached and when 
to stop, but, being entertained and amused 
by the cunning little ways, quite forgets 
that the baby's strength is still feeble, that 
the brain is just beginning its activity and 
development, and is still weak from lack of 
exercise. 

From earliest infancy the child's own 
resources should be allowed to develop, 
and the interference of the adult should 
be so infrequent that when it does occur 
it will come as a treat to the child, and will 
be something to look forward to from day 
to day with expectancy and pleasure. It 
is the pleasures that come but seldom in 
one's life that are most enjoyed and appre- 
ciated; the ones that occur every day, or 
with clock-like regularity, soon pall upon 
one and cease to be pleasures. By con- 
stantly amusing and entertaining the in- 
fant his brain is being over-stimulated, all 
Jiis nerves are being brought into constant 

7? 



SLEEP AND AMUSEMENT 

activity and made to respond to man's 
superior force, strength, and endurance. 
Each nerve becomes as an electric wire, 
emitting spark for spark by contact. 

One would not expect an infant of a few 
weeks or months to walk and talk, or to 
be physically as well developed as a child 
of several years. Why, then, should we 
expect the brain, the most delicate and 
sensitive organ in the whole body, to de- 
velop so much faster than any other mem- 
ber? It is neither right nor safe to force 
it. It is far better to allow the baby to 
take his amusement and mental develop- 
ment into his own hands, at least for a while ; 
he will not go beyond his powers of en- 
durance, and the progress will be slow and 
sure as the child grows older. Very little 
amusement outside of his own resources 
will suffice for him at first, as, for instance, 
taking the baby into another room, where 
he will find new objects to attract his atten- 
tion. When old enough to sit up, looking 
out of the window opens up a new world 
for him. But let the baby find out the won- 
ders for himself; do not keep continually 
forcing different objects upon him, or he 

73 



THE BABY 

will soon tire of them. As the child grows 
strong and can hold things in his hands, 
a soft ball of bright color, a rubber toy, or 
perhaps a bright picture or two, are all he 
needs for perfect enjoyment; do not make 
the mistake of forcing numberless toys of 
endless variety upon him. For if this is 
done he soon becomes tired ; he is sur- 
feited with amusement, and cares for none 
of them. A child is much happier with 
one simple object of amusement, one with 
which he works out the play according to 
his intelligence and capacity, than he is 
with a dozen more elaborate toys far be- 
yond his comprehension, and with which 
the adult tries to amuse him. The writer 
has seen a convalescing child of little over 
a year play by the hour, in perfect content- 
ment, with a little fluff of cotton left on his 
crib; this form of entertainment satisfied 
the child for many days, when many other 
attempts at amusement on the part of the 
nurse, and an endless variety of toys, had 
failed to attract the slightest expression of 
pleasure or interest. The child, if left to 
himself, will invent numberless methods of 
getting pleasure out of the simplest agent, 

74 



SLEEP AND AMUSEMENT 

and will work with the greatest deliberation 
and without undue excitement. 

As the physical development goes on still 
further, the child becomes more active, runs 
about, and resembles a machine of perpet- 
ual motion; his mental activity also in- 
creases. Surely now he does not need to 
be entertained or urged on still further, but 
he does need intelligent restraining, and 
the little mind must be amused and trained 
while being taught. The child at this 
age requires more variety than the infant; 
there is often a surplus energy which must 
be made use of and worked off, and a good 
romp or play is a most healthful way to do 
this. But romping and exhilarating exer- 
cise must be indulged in during the early 
part of the day, and all mental activity and 
excitement should be gradually dropped as 
evening draws near. Violent playing or 
exercise should not be indulged in just be- 
fore going to bed, otherwise the child will 
not go to sleep readily ; he will be restless, 
and have disturbing dreams. 

The babies who from birth are constantly 
amused, whose every wish is gratified, and 
who are continually entertained by some 

75 



THE BABY 

older person, are usually nervous or dull 
as they grow up, and are rarely happy 
boys and girls. This is because they sim- 
ply lack properly developed resources of 
their own. 

There should never be such a thing as a 
nervous baby or child. When a mother 
makes the statement, as so many do, that 
her baby is very nervous, that "he was 
born so, and, consequently, needs most 
careful watching and humoring," it reflects 
very much on that mother as a woman of 
intelligence and good judgment. The in- 
fant is not born nervous. It is true he may 
be born of nervous parents and with nervous 
tendencies ; but because there is such a ten- 
dency, is this any reason why it should 
be nourished, carefully tended, and culti- 
vated as though it were a thing to be de- 
sired? Is it necessary to continually add 
fuel to the fire? No, most emphatically 
no. Instead of this, every means should 
be employed from the beginning of life 
to quiet and eliminate any such tendency. 
These children born of nervous parents 
are, above all others, the very ones w T ho 
should be most carefully guarded from all 

7 6* 



SLEEP AND AMUSEMENT 

kinds of excitement in the way of constant 
amusement and humoring. 

A nurse for such children should be most 
carefully selected, not for her powers of en- 
tertainment, but for her calm and quiet 
manner. She should be a person absolute- 
ly healthy and without nerves. A nervous 
or excitable person should never undertake 
the care of children or babies, as little chil- 
dren, especially delicate ones, are most sus- 
ceptible to either a quieting or a nervous 
influence. 

After a child has passed its second year, 
as much of the child's amusement should 
be out of doors as possible. Leave the nur- 
sery and its toys for rainy days. In pro- 
viding amusement for the children as they 
grow older, it would be well to observe a 
little the methods of the Germans. In every 
German city, no matter how small, you 
will find the city dotted with small and 
shady parks. Every park has several clean 
beds of sand, and here the German nurse 
brings her little charges for amusement. 
The children make for the beloved sand-beds 
the moment they enter the park, while the 
nurse keeps one eye on the child, the other 

77 



THE BABY 

I 

on her mending or knitting. Here one 
sees numbers of little children, varying in 
age from the tiniest toddler to the child of 
five or six years, each one intent on work- 
ing out its own individual scheme or 
form of amusement. The contented, happy 
little faces, the little shouts of delight when 
some cherished idea or plan is worked out, 
whether it be a pie, a bridge, a landscape, 
or merely a hole in the sand, all show a 
pleasure so keen that it is to be very 
much doubted if any toy or number of 
toys invented by man for a child's amuse- 
ment could ever produce so much delight. 
The minds of children in Continental Eu- 
rope are rarely ever forced; one almost 
never sees a toy which requires the brain 
of a child ten or or twelve years old to 
manipulate or understand in the hands of 
a child three or four years, or even older; 
a child in these countries grows to his 
amusement, as he does to his education, 
by degrees. 

When a child is old enough to enjoy books 
and to have stories read to him, be careful in 
selecting them. It is an incomprehensible 
fact that the average adult, in choosing 

7 8 



SLEEP AND AMUSEMENT 

pictures, rhymes, and stories for children, 
almost always picks out those which abound 
in tales of the naughty and mischievous do- 
ings of children, and the harrowing things 
which happen to them. They also tell of 
wicked giants, and cruel relatives who 
leave "babies in the woods" to starve and 
die. These stories are abominable, and 
leave most vivid and lasting impressions 
on the active brain of the child. 

It is hardly fair to the child, with his 
rapidly developing mind and vivid imag- 
ination, to make these examples of wick- 
edness and wrong-doing most prominent, 
and then expect the child to gain his knowl- 
edge of what is good and right from them; 
neither is it reasonable to fill the child's 
mind with examples of the other extreme — 
the goody-good creatures who never ex- 
isted, and are so unnatural that even the 
child has some doubts as to their reality. 
In the whole scheme of amusement for the 
child, his play, games, story-books, etc., 
from the earliest moment of reasoning, let 
plain, sensible good be the guiding key- 
note, simply because it is right. Habit is 
so strong that, if the child is originally 

79 



THE BABY 

started and afterwards guided aright, he 
will naturally grow in that direction. 

Children should be allowed to see stran- 
gers and mingle with their elders often 
enough to be perfectly natural and unaffect- 
ed with them ; but it is a very bad habit to 
exhibit the children and display their tal- 
ents and wise ways, and admire them 
when they are brought into the presence 
of their elders. There are few things more 
ruinous to a child's character. 



CHAPTER VI 

INFANT FEEDING 

FT is estimated that about two -thirds of 
■*■ all children die before reaching the 
third year, also that most of the sickness 
in infants is due to improper food; from 
this it can readily be seen how important 
it is that an infant should have a right 
start in life with the right kind of food, 
intelligently administered and prepared. 

The first three or four months of a baby's 
life are telling ones, and mean much for 
the future health of the child; the food 
which nature provides for the baby is hu- 
man, or mother's, milk ; if this fails, the next 
thing to do is to provide a substitute as 
near like it as possible. The basis of an 
artificial food for an infant should be the 
fresh milk of some animal. In America, 
as cow's milk is about the only milk that 
can commonly be obtained, it is the only 
6 81 



THE BABY 

one that will be considered. As the milk 
of the cow is much stronger in some of its 
elements than mother's milk, it has been 
the work of some of our best physicians, 
with the aid of scientists, to change one or 
more of these elements without changing 
others, thus bringing it to the constituency 
of mother's milk, and adapting it to the 
use of infants. The process of changing 
one or more of the ingredients of cow's 
milk, and adjusting it to an infant's di- 
gestion, is called modifying milk, and the 
food so prepared is called modified milk, 
adapted milk, and sometimes humanized 
milk. Every housekeeper knows that milk 
varies in richness, so it is quite impossible 
to give the composition of milk in any but 
general terms. The milk of all animals 
is composed of fat (butter) — this is almost 
all found in the cream — proteid (curd), su- 
gar, mineral matter, and water. There are 
also a number of other ingredients, which, 
although undoubtedly of importance, are 
present in too small quantities to be con- 
sidered. The fat and sugar furnish the heat 
to keep the body warm, and the power nec- 
essary to move the muscles and keep the 

82 



INFANT FEEDING 

heart going ; they also form about five-sixths 
of the solid ingredients of mother's milk. 
The proteids (curds), which are similar in 
composition to lean meat, go to form the 
muscular tissues of the body, while the 
mineral matter goes chiefly to form bone 
and teeth. The quantity of fat and sugar in 
cow's milk is about the same as in mother's 
milk, but the quantity of proteids, or mus- 
cle food, is about four times greater in the 
former than in the latter. The proteids 
of cow's milk form coarse, solid curds, 
while the proteids of mother's milk form 
soft, flaky curds in the stomach. The 
cow's stomach is accustomed to coarse, 
tough food, like hay and grain, while the 
human stomach is accustomed to soft 
food, which is usually cooked and chewed. 
As the calf grows about four times as fast 
as a baby, it could hardly be expected that 
cow's milk, that was intended for a calf's 
stomach, would answer for a baby's. 

The milk of one cow is not as good as the 
mixed milk of several or a herd of cows. 
The milk of one individual cow is apt to 
vary from day to day, even from milking 
to milking. This is entirely overcome 

83 



THE BABY 

when the milk from a number of cows is 
mixed, as in this way milk quite uniform 
from day to day is obtainable. The milk 
should be strictly clean, as a large part 
of the sickness of infants, especially during 
the summer months, is caused by dirt 
which gets into the milk during milking. 
This dirt is full of bacteria or germs. Some 
of these germs are the ones that produce 
acid and are the cause of milk souring; 
others produce the delicate flavor of butter 
or cheese, and still others cause vomiting 
and diarrhoea; these latter are usually 
the germs caused by stable filth, which 
drop into the milk during the process 
of milking, and produce substances called 
toxins, and are really poisonous to the in- 
fant. No matter how careful the milker, 
or how clean the cows are kept, some germs 
will get into the milk. Fortunately, these 
germs do not develop rapidly in cold milk, so, 
by cooling the milk as soon as it is milked, 
their growth is almost completely retard- 
ed. This fact has been most satisfacto- 
rily demonstrated by eminent chemists re- 
cently. This cooling process, however, must 
be done immediately after milking; if de- 

8 4 



INFANT FEEDING 

layed, the milk will soon be teeming with 
bacteria, as the warmth of new milk is very 
conducive to their growth, and causes them 
to multiply very rapidly. The germs of 
typhoid and other infectious diseases that 
are sometimes found in milk seldom come 
from the cows themselves, but from the per- 
son who milks, or from impure and dirty 
water used in washing dairy utensils. 
Pasteurization is the only means of getting 
rid of these germs. The best milk is ob- 
tained by having the cows kept thoroughly 
clean, the milker to have clean hands and 
clothes, and milk mixed and cooled to be- 
low 60 degrees Fahrenheit, and as soon as 
possible after milking put in quart bottles 
and kept cool. To prevent contamination, 
milk should be carefully bottled and sealed 
at the dairy, and served direct to the con- 
sumer in the same glass bottles. Milk 
that is sent to the city in bulk, then bottled 
by the dealer and served to customers, is 
not fit for an infant's food. Milk to be 
used for babies should never be kept in 
open or tin vessels, and should not be left 
uncovered in a refrigerator where meats, 
vegetables, and various other things are 

85 



THE BABY 

kept. Do not use preservatives of any 
kind; pasteurization or sterilization is the 
only means of preserving milk. I will de- 
scribe this process later. 

To Modify Milk 

As has been stated before, fat and sugar 
are found in about the same proportions 
in cow's milk as in mother's milk, but there 
is four times as much proteid (curd) in the 
former as in the latter. As the infant 
does not grow as rapidly as the calf, it 
does not require nearly as much of this 
proteid, or muscle food; consequently it 
must be reduced without reducing the fat 
and sugar. One of the first things to be 
considered is how to do this. If plain milk 
be diluted, while the proteid is reduced, 
so are the fat and sugar, which, of course, 
is not desirable. It is necessary, therefore, 
to start out with a milk which is richer 
in fat than plain milk. In some of the 
large cities there are laboratories where 
physicians can have an infant's food put 
up on a prescription, the same as medicine 
at a drug -store; but the expense is con- 

86 



INFANT FEEDING 

siderable, thus putting this food out of the 
reach of the great majority. The food 
for most infants will have to be prepared 
in the home from cow's milk, so the mother 
should know how good milk can be pro- 
duced, how to care for it, and how to mod- 
ify or adapt it to her infant's digestion. 
Various methods of doing this have been 
followed, and mixtures of cream, sugar, and 
diluted milk have been introduced, some 
taking the names of the doctors who intro- 
duced them; but these methods have all 
been more or less complicated and hard to 
follow. Within the past year or two im- 
proved and simpler methods have been 
devised, which make modification of milk 
at home a comparatively easy matter. 
When milk is put up in bottles at the dairy 
the cream commences to rise immediately, 
and usually by the time the milk is deliv- 
ered to the family a distinct layer of cream 
can be seen in the upper part of the bottle. 
This cream contains nearly all the fat that 
is in the quart of milk; the fat, being 
lighter than the other ingredients, rises, of 
course, to the top. The other ingredients, 
however, remain the same; they neither 

87 



THE BABY 

rise nor separate, consequently are in the 
cream in the same proportion as in the 
plain or whole milk. So cream is milk, 
containing the same amount of sugar 
and proteid as plain milk, only very much 
richer in fat. The relation of cow's milk 
to human milk stands about in this pro- 
portion: Cow's milk, 4 per cent, fat, 4 per 
cent, sugar, 4 per cent, proteid; mother's 
milk, 4 per cent, fat, 7 per cent, sugar, 1 Yz per 
cent, proteid. Now, by using the top nine or 
ten ounces of bottle milk, which has stood 
long enough for the cream to rise, we get a 
milk that is three times as rich as either 
plain cow's or mother's milk. By taking 
fourteen or fifteen ounces of the top milk, 
we have milk only twice as rich in fats ; by 
diluting this top milk with boiled water or 
gruel, and adding a little sugar, we have 
a food closely resembling the human milk. 
The object in modifying cow's milk, it will 
be seen, is to make the infant's food con- 
tain the heat-producing and tissue-building 
ingredients in about the same proportions 
as are found in mother's milk. This proc- 
ess consists in selecting clean milk, re- 
moving a portion from the top after the 

88 



INFANT FEEDING 

cream has risen, diluting it, and adding 
sugar. 

Order from the milkman bottled milk; 
or, if you have your own cow, observe the 
rules for cleanliness, cooling, and bottling 
that are given earlier in the chapter. When 
the cream line shows distinctly, which it 
does if allowed to stand in a cold place over- 
night, remove from the bottle the top nine, 
fifteen, or twenty ounces, as is called for in 
the food mixture the baby is to take. This 
can be easily removed by a one- ounce tin 
dipper,* as shown in the illustration on the 
following page. The first dipperful will 
have to be removed with a teaspoon. Al- 
ways dip out the amount called for in a 
food formula, as a less quantity would be 
too rich in fat, and may upset an infant's 
digestion. What is not used can be put 
back in the bottle. 

There has been considerable discussion 
among physicians as to what milk should 
be diluted with; some use boiled water, 
others gruels, and still others digested 
gruels. It is now conceded by leading 

* A one-ounce dipper can be obtained by sending 
5 cents to Cereo Co., Tappan, N. Y. 

8 9 



THE BABY 

authorities* that diluting cow's milk with 
gruels renders the curds softer and much 
more digestible than by diluting with 
boiled water. The advantage of using 
digested gruels is that, in cases of indi- 




ONE-OUNCE TIN DIPPER 



* Recent authorities consulted : L. Emmet Holt, 
M.D., " The General Principle of Infant Feeding/' 
New York Medical Journal, January 12th, 1901 ; 
Henry D. Chapin, M.D., " A Simple and Accurate 
Method of Substitute of Infant Feeding," New York 
Medical Journal, February 23d, 1901 ; Floyd M. 
Crandall, M.D., "Practical Food Prescribing," 

90 



INFANT FEEDING 

gestion, vomiting, and diarrhoea, they form 
the best temporary substitute for milk. 
The preparation of gruels and digested 
gruels will be described later. 

How to Feed a Healthy Baby 

For the first few days after birth the 
baby does not get milk from its mother, 
but collustrum, which is quite different 
from milk. For this reason strong food 
must be avoided by the mother during the 
first few days of the baby's life. In start- 
ing out with a food for a bottle-fed baby 
there is apt to be disturbance at first, unless 
care is used in selecting a weak food. No 
two babies are alike. Some babies will thrive 
on a mixture that would cause indigestion 
in other babies of the same age. By trying 
is the only way to find out what will suit 
an infant's digestion. Consequently, the 



Medical News, May nth, 1901 ; Charles G. Kerley, 
M.D., " Treatment of Summer Diarrhoea in In- 
fants," New York Medical Journal, August 4th, 
1901 ; Thomas S. Southworth, M.D., " Medical 
Treatment of Summer Diarrhoea, " Medical News, 
July 13th, 1901. 

91 



THE BABY 

only safe way to feed is to begin with 
all babies on a weak food, and gradually 
increase the strength. Let the baby's di- 
gestion and weight be the indication for 
increase in quantity and strength. A 
healthy baby should gain steadily about 
four ounces a week during the first few 
months of life. With the baby fed arti- 
ficially, or on the bottle, a fact too often 
overlooked is that an occasional change of 
diet is needed. With the breast-fed baby 
its diet is a slight but constant change, 
brought about by the varying diet of the 
mother. In suggesting a change for the 
bottle-fed baby it is not meant to use 
an entirely different food, but that as the 
child grows the strength of food should 
increase; some new ingredient or change 
of diluent should be made occasionally, 
such as for a time substituting wheat or 
oat-meal gruel for barley, later giving 
beef-juice three or four times a week, still 
later a teaspoonful of orange juice once 
in a while. Do not keep a child on fluid 
diet too long. At the end of twelve months 
begin to give a mixed diet, but not before. 
Start out at first by giving well-cooked ce- 

92 



INFANT FEEDING 

reals and meat broths, not scorning a bone 
to suck frequently. Vary the kinds of ce- 
reals and broths ; after a while a soft-boiled 
egg may be tried once or twice a week, 
beginning with half a one at first; by 
the time the eighteenth month is reached, 
scraped beef or beef pulp may be given, 
also stewed or baked fruits. Avoid too 
much sweets, especially chocolate. If the 
child's digestion is good, do not abuse it 
by overfeeding or by giving indigestible 
dainties. A healthy child gains steadily; 
if not, there is something wrong — either he 
is getting too little food or too much, or the 
food is not the right kind — and a physi- 
cian should be consulted. 

The Administration of Food 

Next to selecting the right food for the 
infant, the proper manner of administering 
it should be considered. A perfect food, 
if given with disregard to regularity or 
quantity, is likely to upset the infant. No 
matter whether the baby be breast-fed or 
bottle-fed, it should be fed only at regular 
intervals, and the same amount of food 

93 



THE BABY 

should be given at each feeding. The in- 
tervals between feedings vary according to 
the age of the baby, from two to three or 
four hours; the time allowed for the in- 
fant to take what is necessary for him is 
from twenty to twenty - five minutes. A 
strong, healthy child will often take his 
food in a much shorter time, but twenty 
minutes is the time necessary for the aver- 
age infant. During this period the baby 
should not be allowed to fall asleep, drop the 
nipple, and look about or play, but should 
be kept strictly at business. If the child 
refuses food, or only cares for part of a 
nursing, do not force him, as the little stom- 
ach knows best when it has had enough 
or is not in condition to receive more. Do 
not be alarmed if occasionally a child re- 
fuses all or part of a feeding; it does not 
necessarily indicate that anything is wrong 
or that he is ill, merely that the stomach 
is taking a little needed rest. A baby 
should always be held in a semi-upright 
position while taking its food, except at 
night, when he should lie on his side, and 
be kept awake until the twenty minutes 
are up; he should then be immediately 

94 



» 



INFANT FEEDING 

taken from the breast or the bottle re- 
moved. Babies fed with precision and 
regularity seldom suffer from indigestion; 
good digestion usually means health, and 
a healthy baby is a good sleeper at night. 
As the infant's body compares in size with 
the adult's, so in the same proportion does 
the size of the stomach compare. Experi- 
ence has also taught us that it takes about 
two hours, hardly ever less, more often a 
little longer, for an infant to digest its 
food. Do not, then, crowd in a meal of 
six ounces or more when there is only 
capacity for three or four ounces, and do 
not force a second meal when the first 
one has not yet been disposed of. The 
adult's stomach needs rest at night, then 
why not the infant's? He takes just as 
much food in proportion to his size as the 
adult. Put yourself in his place. Who 
could stand having food put into his 
stomach every hour or so, and at irregu- 
lar intervals, both day and night? Many 
of the most stubborn cases of gastric dis- 
turbance in infants start just in this way. 
Do not imagine that every time a baby 
cries it is from hunger, and give him 

95 



THE BABY 

something to eat, or conclude, because he 
takes food an hour after he has been fed, 
that this, too, is hunger; persons suffering 
from indigestion usually crave food. An 
infant irregularly fed is usually overfed; 
in this case he is neither satisfied nor prop- 
erly nourished by his food, and is almost 
sure to develop gastric symptoms. 

Intervals and Formulas for Feeding 

In feeding a new-born infant always 
begin by using the first formula, then the 
second, and so on. For the first three or 
four weeks the baby should be fed every 
two hours during the day, between 6 A.M. 
and 6 P.M. There should be two night 
feedings, 10 P.M. and 2 A.M. At one month 
the intervals should be two and one -half 
hours apart, commencing at 6 A.M., ending 
at 6.30 P.M. Two night feedings, 10 P.M. 
and 2 A.M. As the baby grows in strength, 
he requires stronger food and more of it, 
consequently he does not need to be fed as 
often. From two months on he need only 
be fed once in three hours from 6 A.M., and 
only one feeding at night, at 10 P.M. 

96 







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PUTTING ON THE BAND 



INFANT FEEDING 

For formulas Nos. I, 2, and 3, first re- 
move the top nine ounces from a quart 
bottle of milk. Of this top nine ounces 
use only as much as the formula you are 
making calls for; the rest can be put back 
in the bottle. Either sugar of milk or 
cane sugar may be used for sweetening; 
if the latter be employed, use only one- 
half as much as of the sugar of milk, as 
cane sugar is twice as sweet. Those who 
do not have a graduated measuring-glass 
should remember that two tablespoonfuls 
equal one ounce. 

Formula No. I 

Fifteen ounces of food, one-seventh of which 
is milk. 

Of the 9 ounces top milk take 2 ounces. Of 
boiled water or gruel take 13 ounces. Of sugar 
of milk take 2 even tablespoonfuls. 

Mix and put in ten bottles, i J /2 ounces each. 
Feed every two hours during the day, twice dur- 
ing the night. 

Formula No. 2 

Thirty-two to thirty-six ounces of food, one- 
sixth of which is milk. 
Of the 9 ounces top milk take 4 to 6 ounces. 
7 97 



THE BABY 

Of boiled water or gruel take 24 to 26 ounces. 
Of sugar of milk take 2^ even tablespoonfuls. 

Mix and put in ten bottles, 2 to 3 ounces each. 
Feed every two hours during the day, twice dur- 
ing the night. 

Formula No. 3 

Thirty-six to thirty-eight ounces of food, one- 
quarter of which is milk. 

Of the 9 ounces top milk take 7 to 8 ounces. 
Of boiled water or gruel take 26 to 28 ounces. 
Of sugar of milk take 2^/2 even tablespoonfuls. 

Mix and put in eight bottles, 4 to 5 ounces 
each. Feed every two and a half or three hours 
during the day, once at night. 

Formula No. 4 

Thirty-six to thirty-eight ounces of food, one- 
third of which is milk. 

From a quart bottle of milk take top 16 
ounces. Of boiled water or gruel take 26 
ounces. Of sugar of milk take 3 even table- 
spoonfuls. 

Mix and put into six bottles, 6 ounces each. 
Feed every three hours during the day, once at 
night 

Formula No. 5 

Forty-two ounces of food, one-half of which 
is milk. 

98 



INFANT FEEDING 

From a quart bottle of milk take top 20 ounces. 
Of boiled water or gruel take 20 ounces. Of 
sugar of milk take 4 even tablespoonfuls. 

Mix and put into six bottles, 7 ounces each. 
Feed every three hours during the day ; no night 
feeding. 

Formula No. 6 

Forty-eight ounces of food, two-thirds of which 
is milk. 

Of plain or whole milk take 1 quart. Of boiled 
water or gruel take 16 ounces. Of sugar of milk 
take 4 even tablespoonfuls. 

Mix and put in six bottles, or feed from cup 
8 ounces every three and a half hours ; no night 
feeding. 

Pasteurization and Sterilization 

An advantage which the breast-fed in- 
fant has over the bottle - fed one is that the 
human milk is practically sterile ; at any 
rate, germs are only occasionally found in 
it, while, as we now know, unless great 
care is exercised, cow's milk has many. 
The only way to overcome this difficulty 
and render cow's milk perfectly sterile 
and preserve it is to pasteurize or sterilize 
it. The only difference between these 

99 
LOFC. 



THE BABY 

two processes is that the latter is a longer 
process, and the heat is carried to a much 
greater degree. This causes certain chem- 
ical changes which gives the milk a cooked 
flavor. Sterilization is not necessary un- 
der ordinary circumstances, unless the milk 
is to be kept for a long while or taken on 
a long journey. Pasteurization consists in 
heating the food rapidly to 150 or to 165 de- 
grees Fahrenheit, and then rapidly cooling 
it; this kills the germs that cause many 
of the intestinal diseases in children, as 
well as most of the germ diseases, includ- 
ing tuberculosis. It should be well borne 
in mind, however, that neither sterilization 
nor pasteurization, boiling, or any other 
process will make bad milk good or sour 
milk sweet. The process of pasteurization 
is a simple one, and numerous varieties of 
apparatus for this purpose can be bought. 
Among the best are "The Arnold" and 
" The Freeman Pasteurizer." With both of 
these come full directions for pasteurizing. 
A home-made pasteurizer can be construct- 
ed with little expense, and will answer the 
purpose as well as a more expensive 
outfit 

100 



INFANT FEEDING 

Home-made Pasteurizer and How to Pas- 
teurize Milk 

For a home-made pasteurizer the follow- 
ing are necessary: A large tin pail, with 
cover, size about nine inches in depth and 
eight inches in diameter; have a thin disk 
or false bottom made, the circumference 
of the pail; this should be perforated and 
on wire supports or legs, so as to stand 
an inch from bottom of pail; an inverted 
tin pie-plate, perforated, will make a good 
substitute. Have a hole cut in the cover 
large enough to be fitted with a good-sized 
cork, through which you can punch out 
or burn a hole broad enough for a chem- 
ical thermometer to be passed through ; the 
bulb of the thermometer should reach the 
water, thus enabling one to watch the tem- 
perature closely, as this should be care- 
fully observed. In preparing the food, 
first measure the different ingredients in 
the right proportions, and then place in a 
pitcher and mix well together; pour the 
exact amount of food for each feeding in 
as many bottles as there are feedings in 
twenty-four hours; cork the bottles as 

101 



THE BABY 

tightly as possible with plugs of cotton, 
and place your bottles in the pasteurizer 
with enough cold water to reach just above 
the food in them. The pasteurizer should 
then be placed over a hot fire, and the 
water rapidly heated to a temperature from 
150 to 160 in winter, from 155 to 165 in 
summer. Watch the thermometer, and as 
soon as this degree of heat is reached re- 
move the pasteurizer from the stove, and 
cover with a cosey made of some heavy 
cloth ; this is to help it retain the heat. Let 
it stand for ten or fifteen minutes, then cool 
the food as rapidly as possible to 50 °, or 
lower, by first placing the bottles in luke- 
warm water, gradually cooling it until the 
proper degree is reached. The bottles 
should then be placed in a refrigerator or 
cool place, where the temperature is never 
allowed to go above 60 °. Milk thus cared 
for will keep perfectly from twenty-four to 
forty-eight hours; it is desirable, however, 
for an infant to have a fresh supply once 
every twenty-four hours. 

The following points should be careful- 
ly observed in pasteurizing : Procure fresh 
milk, free from impurities; rapid and uni- 

102 



INFANT FEEDING 

form heating; perfect control of tempera- 
ture; rapid and uniform cooling. 

To heat the food before giving it to the 
baby, place bottle in a pail or saucepan 
of hot water (not boiling) for about five 
minutes; do not remove cotton plug until 
you are ready to give food to the baby, 
then replace it immediately by nipple; do 
not allow nurse or any one else to test tem- 
perature of milk by drinking from bottle 
or putting nipple in mouth; test by letting 
a few drops fall on the tongue or wrist. 

Care of Bottles and Nipples 

To insure clean food, the bottles and 
nipples, in fact all the utensils used in 
preparing the infant's food, must be kept 
absolutely sweet and clean. If the baby 
be a nursing one, the breast and nipple 
should be bathed before and after nursing. 
A young baby ought also to have its mouth 
washed after each nursing, because at a 
very early age the secretion of saliva is 
either scanty or entirely absent, and it does 
not carry all the food from the mouth; 
that which remains is likely to ferment, 

103 



THE BABY 



causing thrush or sprue. As the infant 
grows, the saliva increases and keeps the 
mouth free from food; then twice a day is 
enough to wash the mouth. When the 
infant is bottle-fed, do not allow the bottle 
to stand one minute after the baby has 
finished. Bottles and nip- 
ples need immediate attention. 
First fill the bottle with cold 
water, and let it stand while 
the nipple is being cleaned. 
Thoroughly wash the nipple, 
both inside and out, with clean, 
cold water, until not a trace 
of milk is left; then pour 
scalding water through it, and 
place in a cup or small glass 
filled with a solution of boric 
acid, borax and water (as much borax 
as would go on a dime to a cup of 
water), or bicarbonate of soda and water 
(quarter of a teaspoonful of the soda to 
the cup of water). Nipples cared for in 
this way will always be sweet and clean, 
and do not require boiling. Boiling softens 
the rubber and renders the nipple unfit for 

use, and also gives an unpleasant odor and 

104 




HIPPLE 



INFANT FEEDING 



taste to it. It is best to have two nipples 

at hand, using them alternately. Do not 

keep them in use too long ; 

a frequent change to new 

ones should be made. A 

simple black-rubber nipple 

is the best. 

The best bottle is a 
round, graduated one, 
with a wide neck, as it 
can be more easily and 
thoroughly cleaned. Im- 
mediately after feeding, 
clean the bottle by first 
carefully rinsing in cold 
water; then let it stand 
filled with the boric acid 
solution, borax and water, 
or the bicarbonate of soda 
and water; finally pour 
off this water and place 
the bottle in scalding soap- 
suds, best made with a good soap pow- 
der; with the aid of a stout bottle brush 
give the bottle a thorough washing, then 
rinse in clean hot water several times and 
set to drain. Before putting in the food, 

105 




NURSING BOTTLE 



THE BABY 

rinse once again in scalding water. All 
utensils used in the preparation of food — 
pitchers, measuring-glasses, spoons, tin dip- 
per, etc. — should be washed in the same 
way, not a particle of milk or grease being 
left to become sour or rancid. 

Gruels 

To prepare gruels as diluents for cow's 
milk, use either barley, oat-meal, wheat, or 
rice. 

Barley Gruel. — Beat up one teaspoon- 
ful of Robinson's prepared barley, or Health 
Food barley flour, in a little cold water; stir 
this into a pint of boiling water, and boil 
in double boiler for fifteen minutes. Strain 
if not perfectly smooth. 

Oat-meal Gruel. — Two heaping teaspoon- 
fuls of flaked oats to one pint of boiling 
water; boil fifteen minutes in double boiler. 

Wheat or Rice Gruel. — Use the wheat 
or rice flour and make as barley gruel. 

To Make Digested Gruels 

To any of the above gruels add one tea- 
106 



INFANT FEEDING 

spoonful of Cereo, a digestive preparation, 
to one quart of gruel when cold enough 
to be tasted. Gruel can be quickly cooled 
by setting the vessel in which it is made 
in cold water for three or four minutes. 
In cases of vomiting and diarrhoea, it is al- 
ways safe to stop all milk feedings at once, 
and give digested gruel until the doctor 
arrives. It is also a good plan in summer, 
when there is vomiting of night feedings, 
to substitute gruel, as it is possible during 
warm weather for the food which stands 
longest in the bottles to undergo a slight 
change, enough to cause the baby to vomit. 
In cases of vomiting and diarrhoea, where 
the food is to be digested gruel for one or 
several days, the gruel can be made twice as 
strong, viz., two teaspoonfuls of the barley 
or other flour to one pint of water. Cereo 
quickly thins gruel. Season gruels by add- 
ing a pinch of salt and a very little sugar. 
When Cereo is used, leave out the sugar. 

Arrow-root Water 

Two teaspoonfuls of arrow - root, rubbed 
smooth with a little cold water; stir into 

107 



THE BABY 

one pint of boiling water; boil five min- 
utes, strain, add a pinch of salt and a little 
sugar. This is good in cases of summer 
complaint. 

Egg or Albumen Water 

One pint of cold water, the white of one 
egg, one teaspoonful of brandy; beat to- 
gether well. In cases of persistent vomit- 
ing this will be retained by the stomach 
when everything else is rejected. 

Lime-water 

As lime-water will keep indefinitely, it 
is well to have it on hand. To make it, 
take a lump of ordinary lime, the size of 
a teacup, place it in a small stone crock 
or jar, holding two quarts or more, add a 
pint of water to the lime, and let it slake. 
When slaked, stir in another pint of water 
and let it settle. After it has settled pour 
off the water, as it contains the impuri- 
ties of the lime. The jar can then be filled 
with water. When again settled, siphon off 
with a piece of soft rubber tubing, or care- 

108 



INFANT FEEDING 

fully dip off enough water to fill a bottle 
of any desired capacity. If you wish the 
lime-water to be perfectly clear, filter through 
absorbent cotton placed in a glass funnel, 
or through filter paper. Cork bottle, and 
set aside for use. The large jar can be 
replenished with water from time to time 
as long as there is any lime left in it. Lime- 
water is used in milk when there is vomiting 
and diarrhoea, in the proportion of one 
teaspoonful of lime-water to sixteen tea- 
spoonfuls of food. 

Bicarbonate of Soda 

When there is vomiting with constipa- 
tion, use bicarbonate of soda, fifteen grains 
to each pint of milk; this will often cause 
the trouble to cease. 

Broth 

Mutton Broth. — One pound of mutton 
(the neck is best), cut in squares about two 
inches in size; cover with one pint of cold 
water and set on stove where it will simmer, 
not boil, for four or five hours; strain, add 

109 



THE BABY 

pinch of salt, and let stand until cool, then 
skim off every particle of fat. When the 
broth is cold it should be of the consist- 
ency of jelly. This broth is especially 
good in cases of summer diarrhoea; it 
can be taken hot or cold, in the jellied 
state. 

Chicken Broth. — From one fowl take all 
the meat and cut it in half-inch squares, 
being careful to remove all fat from the 
meat; to a pound of meat add a pint of cold 
water, and proceed as in mutton broth. 

Beef Tea. — Use the round of beef and 
make as mutton broth. 

Beef Juice, No. I 

One pound of round steak, about one and 
a half inches thick; broil slightly on both 
sides, or place in very hot oven for a few 
minutes; then squeeze through a meat press 
or lemon squeezer and season the juice with 
a little salt. Give cold or slightly warmed. 
From two to four ounces of the beef juice 
should be obtained in this way. To warm 
beef juice, set the receptacle which holds 
it in hot water and slowly stir; it must not 

no 



INFANT FEEDING 

heat too much or too quickly, or it will co- 
agulate. 

Beef Juice, No. 

One pound of round steak cut or chopped 
in small pieces; place in glass jar, and 
pour in four ounces (eight tablespoonfuls) 
of cold water, cover, and put in cool place 
or refrigerator and let stand five or six 
hours ; then strain through a piece of cheese- 
cloth and add a small pinch of salt. Serve 
warm or cold, as No. I. 

Scraped Beef, or Beef Pulp 

Take a piece of round or top sirloin steak, 
not more than three-quarters of an inch 
thick, scrape carefully with a tablespoon, 
first one side, then the other. You have 
then a fine beef pulp, without coarse fibre 
or fat; mould this pulp into a small cake 
and broil over a hot fire, turning fre- 
quently, so it will be basted by its own 
juice; have it rare. Place on a plate, 
break it up with a fork, and season with 
a little salt. For children with delicate 
digestion a teaspoonful of this pulp un- 

iii 



THE BABY 

cooked and seasoned is often beneficial and 
relished by the child. 



Baked Apple 

Pare and core a large, juicy apple, bake 
until thoroughly soft, then strain through 
wire sieve, and sweeten. 



Stewed Prunes 

Place in porcelain stew-pan the required 
quantity of prunes, cover with water, and 
stew slowly until quite soft; then strain 
or rub through coarse sieve; put this 
pulp back in stew-pan with a little of 
the water in which the fruit was cooked, 
also enough molasses to sweeten, and let 
cook for about ten minutes. This is ex- 
cellent as a laxative. 

Stewed Fruit 

In summer, fresh fruit should not be given 
to young children. Fruit is much better for 
them if stewed in a little sugar and strained. 
Pears are not good in any form. 

112 



INFANT FEEDING 

Oat-meal Porridge 

Porridge made from ordinary oat - meal 
should be cooked for one full hour; the 
flaked varieties fifteen minutes to one half- 
hour. Season with a little salt, and serve 
with cream and a little sugar. 

Orange Juice 

Orange juice should always be strained 
through a piece of cheese-cloth or fine wire 
sieve before being given to children. 



CHAPTER VII 

CONTAGION— MEASLES AND SCARLET 
FEVER 

II 7TEASLES is probably one of the most 
"*• infectious of the contagious diseases 
of childhood ; it is considered a mild disease 
which runs a short and usually harmless 
course, unattended with any very grave 
danger. In a certain degree this is true, 
but no disease in children, contagious or 
otherwise, no matter how simple, can be 
considered absolutely harmless, and all 
contagion, no matter how mild the attack 
may be, should be intelligently nursed, 
in order to prevent, if possible, any serious 
complication which might occur. 

To the average healthy child who is from 
four to ten years old, measles is usually 
a slight matter; as a rule, they only suffer 
a few days' acute illness, are then a couple 
of weeks convalescing, during which time 

114 



MEASLES AND SCARLET FEVER 

they usually feel pretty well, and make a 
good recovery without any serious compli- 
cations. But with a child under two years 
old it is quite a different matter; lung 
complications are to be guarded against, 
and the patient more carefully watched 
and nursed. The symptoms and precau- 
tions against spreading the disease, and 
the nursing, are facts which every mother 
should acquaint herself with. The earliest 
symptom of measles is a rather profuse 
running of the nose and eyes, accompa- 
nied by a short teasing cough and con- 
siderable sneezing; it is with these early 
symptoms that the disease is most infec- 
tious. Let a child at this period cough 
only once in a roomful of other children, 
and the chances are that four out of every 
five who have not previously had the dis- 
ease will become infected. The mother, 
the teachers in the schools, the heads of day 
nurseries, the nurse who cares for little 
ones — in fact, any one in charge of chil- 
dren or places where a number of children 
are gathered together — should always be 
on the alert for these symptoms, and a child 
so affected should be immediately isolated 

115 



THE BABY 

from the others. Following the coryza 
comes the rash, which appears in coarse, 
rather crescent-shaped patches. They usu- 
ally are discovered first on the face, which is 
rather swollen, and behind the ears. Oc- 
casionally they are first noticed on the neck, 
under the chin, and from there creep up 
behind the ears and then to the face. How- 
ever, the rash gradually spreads down 
to chest, body, and extremities, and in well- 
developed cases will even be seen on soles 
of feet and palms of hands. As it extends 
to lower part of body, it gradually disap- 
pears from the upper part, face first, and 
so on down until it is entirely gone. My 
experience with very many cases has been 
such that I should consider it far less dan- 
gerous — in fact, ten to one — to allow the 
children to come together for hours after 
the rash is well developed than to be ex- 
posed in the early stages for five minutes. 
The most contagious period of this disease, 
then, is before the rash appears. The next 
step to be considered after a case has 
developed is to prevent the further spread 
of the disease. The period of incubation 
after exposure is usually from ten days to 

116 



MEASLES AND SCARLET FEVER 

two weeks. Some cases do not develop 
until the eighteenth or twenty-first day, 
but this is rare. It is always safe, how- 
ever, to keep the children who have been 
exposed under observation until the end 
of the third week. When the symptoms 
thus described first appear the patient 
should be immediately removed from con- 
tact with other children. Early isolation 
will often prevent an epidemic. If at the end 
of a week no further symptoms develop, no 
harm has been done. If a rash develops, 
then the trouble will have been well worth 
the pains, and the chances are that many 
other children have been saved from being 
infected with the disease. Where there is 
a family of small children and the rash is 
the first intimation that one of them has the 
disease, let the mother not make the com- 
mon mistake of distributing the rest of the 
children among relatives and friends in the 
hope of their thus escaping catching it. 
This is altogether wrong ; the damage has 
already been done, they have been exposed 
at the most dangerous period, namely, a 
few days before the rash appeared on the 
sick child, and the chances are that in the 

117 



THE BABY 

course of a couple of weeks the children 
sent away will come down with the disease 
away from their own home, where they 
would much better be when sick; not only 
this, but they have carried contagion into 
another household, and probably many 
other children have been exposed. It is 
always at this early period that the most 
careful precautions against the spread of the 
disease should be taken. The children 
in a family where a case has developed 
should not be allowed to mingle with other 
children, and under no circumstances 
should they be allowed to attend school, 
until, at the very least, two weeks have 
passed by. If early isolation and strict 
precautions are taken by the mother, teach- 
er, or others in charge of little children, 
much can be done to check this most con- 
tagious of diseases in communities, dis- 
tricts, and schools, and many little lives 
be thus saved. You will find the ounce of 
prevention in this case to be worth ten 
pounds of cure. 

While measles is not necessarily a dan- 
gerous disease, it is one which calls for in- 
telligent nursing. It is a disease which 

118 



MEASLES AND SCARLET FEVER 

rarely, if ever, is carried in the clothing, 
and while it would not be quite safe to 
take a child while in the acute stages on 
one's lap and fondle and press it close to 
the breast, then go from the room and re- 
peat the same act with another child, still 
the mother, sister, or nurse may care for 
the sick child and still be allowed to mingle 
with other members of the family without 
danger of carrying the disease. It would 
be well, however, to keep a wash-dress for 
nursing, and not wear this dress outside 
the sick-room. It is always well to be care- 
ful, and to thoroughly wash hands and face 
before going among others. 

The room used for the patient should be 
large, bright, and well ventilated. Thus, if 
a second child in the family comes down 
with the same disease, which is most sure 
to happen where there are other children, 
the second patient can be placed in the 
same room with the first without crowding, 
or danger of exhausting the supply of 
fresh air, as would be the case in a small 
room. As the eyes are weak and affected 
by bright light, the light in the room should 
be rather subdued. After a few days, 

119 



THE BABY 

when the child is allowed to sit up, a cap 
with a large peak in front is a good device 
to shade the eyes from the glare. The 
room and patient must be kept warm, and 
draughts carefully avoided. When I say 
warm, I do not mean hot. The patient 
should not be kept so warm that he perspires, 
yet it is essential that the hands and feet 
should not be allowed to get cold. In the 
sick-room, as in the nursery, the open fire 
is, if possible, desirable, as a means both 
of heating the room and of assisting in 
the ventilation. 

As the rash begins to disappear the fever 
also subsides, and after about four or five 
days the patient begins to feel as though 
he were well again, and an older child will 
often rebel at being kept in bed. But as it 
is at this stage that the lung symptoms are 
likely to develop, extra precaution must be 
taken; active children are not likely to lie 
perfectly quiet in bed, or neatfy tucked under 
the bedclothes, and it is not absolutely nec- 
essary that they should be kept so ; they will 
be much happier and more comfortable, and 
would also sleep better at night, if frequent 
change of position were made during the 

120 



MEASLES AND SCARLET FEVER 

day. For a little child it is well to have 
a warm bed-sacque to protect the arms and 
chest, so that the patient can sit up in bed, 
and have his toys about to divert and 
amuse him. He can also be taken from 
the bed, and, with the legs well wrapped 
in a blanket, be allowed to sit in a chair. 
An older child may be up, dressed, and 
about the room, but must not be allowed 
to leave it, and should be carefully protected 
from draughts. At the end of two weeks, 
if the child has apparently made a good 
recovery, with no complications, there is 
no reason why he should not mingle with 
the rest of the family, but before leaving 
the room the entire body should first be 
sponged with a solution of bichloride, one 
to five thousand, this to be followed by a 
bath of warm water and soap, precautions 
against draughts still being observed after 
the child has been released from the sick- 
room. If the weather is mild the patient 
can go out at the end of three weeks; in 
winter not until a month has passed. The 
diet, while the patient has fever, should 
be light, such as broths, milk, etc. As the 
fever decreases he may have gruels, soft- 

121 



THE BABY 

boiled or poached eggs, toast, and light des- 
sert. At the end of the first week, if every 
thing goes right, there is no reason why the 
patient should not be allowed ordinary diet; 
only remember that the child, not having 
active or out-of-door exercise, is not as well 
able to digest hearty food as when well. 
While the rash is full on the body, which 
is only for two or three days, the daily 
bath should be omitted; simply bathe face, 
hands, or other parts of the body which 
may be soiled, and dry the patient quick- 
ly. Instead of a bath the patient should 
be rubbed twice a day with almond or 
olive oil; this should be done under cover 
of a blanket, the oil should be warmed, 
and care taken that the child does not suffer 
from exposure while this is being done; 
there is very little danger, however, if the 
room is warm. As soon as the rash has 
faded the child may have a warm sponge 
bath over the entire body each day, and it 
will do no harm to follow the bath by the 
inunctions of oil, continuing these until the 
child is well. With children under two 
years old, measles is not such a simple 
matter. The consequences are much more 

122 



MEASLES AND SCARLET FEVER 

likely to be serious, and for infants under 
one year of age to contract this disease 
is a decided cause for alarm. With older 
children lung trouble rarely follows; if 
it does, usually the most that happens is 
an attack of bronchitis. But with babies 
the chances of pneumonia are a much 
more serious matter, and pneumonia is 
a very grave disease in infants. Fortu- 
nately, however, children under one year, 
especially if they are nursing babies, are 
not very liable to contract this disease, and 
if the mother or nurse is a person of care- 
ful and keen observation, is prompt to de- 
tect symptoms and to remove the suspect, 
there is every reason to assume that the 
infant will escape infection. 

The cleansing of the patient's room after 
an attack of measles is not as serious a 
matter as after scarlet fever or diphtheria, 
but should still be looked after. The room 
should be carefully swept, the walls, if paint- 
ed, rubbed down with a damp cloth, but, if 
papered, rubbed down with bread. Cut the 
loaf lengthwise through the centre and bevel 
the crusty edge; as the bread becomes soiled 
or wears rough, pare it down. Floors, fur- 

123 



THE BABY 

niture, and all wood- work, also, should be 
washed. If the room is then thoroughly 
aired for twenty-four hours there will be no 
danger from the disease, and fumigation is 
unnecessary. It may be well to state here 
that the disinfectant mentioned — bichloride 
of mercury — is a poison, and should be pur- 
chased and used only under the physician's 
prescription and direction. The tablets for 
making the solution should be kept under 
lock and key, that there may be no chance 
of patient or others getting it by mistake. 
Any of the solution left over should be 
thrown away immediately. 

SCARLET FEVER 

While scarlet fever is not as contagious 
a disease as measles, it is a far more seri- 
ous one. It is also of great importance 
that as early a diagnosis as possible should 
be made in order to prevent its spreading; 
most careful isolation, too, is necessary. 
The most malignant forms of this disease 
are contracted from very mild cases; on 
the other hand, only a mild case may re- 
sult from contact with the most serious type. 

124 



MEASLES AND SCARLET FEVER 

Scarlet fever is not common in children 
under one year old. The period when chil- 
dren are most susceptible to this disease 
is between the ages of two and ten years; 
after the latter age it is not nearly so likely 
to occur. The period of incubation, which 
is the time elapsing between the time of 
exposure and the time when the disease 
develops, is from two to seven days, the 
usual time being from forty-eight to fifty- 
six hours; but if the child should not de- 
velop the disease within seven days after 
exposure he can usually be considered 
safe. 

The attack commonly commences with 
a very red, sore throat, fever, and vomiting. 
Isolate a child with these symptoms at once 
and watch for a rash ; if at the end of forty- 
eight hours it does not appear, the child may 
be released. Occasionally in little children 
these premonitory symptoms will not ap- 
pear at all, and the first intimation of the 
disease is a slight rash. Consequently, 
as a precaution, isolate a child immediately 
whenever a rash is discovered, and keep 
the patient away from other children until 
the doctor decides that it is safe for the child 

125 



THE BABY 

to again mingle with them. Sometimes 
mild cases have been known where even the 
rash did not show, and desquamation, or 
peeling of the skin, was the first intimation 
of the disease. The rash of scarlet fever 
is too unlike that of measles to be mistaken 
for it. The rash of measles is in coarse, sep- 
arate red patches, while that of scarlet fever 
is a fine, bright red rash or blush, contin- 
uous and uniform, having a granular sur- 
face, looking somewhat as though the skin 
had been sprinkled with fine sand. When 
the rash is at its height there is often 
a burning and itching sensation and the 
hands and feet are swollen, and by drawing 
the fingers across the reddened surface of 
chest or abdomen they leave a white track 
which will remain for quite a little while; 
the throat is also red and granular, 
often being so before the rash appears 
on the body. White patches are usually 
seen in the throat, especially in older 
children; the tongue is coated a yellowish 
white, with red dots, giving it somewhat 
the appearance of a strawberry; hence the 
name "strawberry tongue." If, as soon as 
these symptoms are discovered, the child is 

126 



MEASLES AND SCARLET FEVER 

isolated, the chances are that the disease 
will not be contracted by any other member 
of the family or others who have come in 
contact with the child, as it is not at this 
stage that the disease is generally consid- 
ered to be contagious, although children 
who have been drinking from the same 
glass or have used the same spoon a short 
time previous to the appearance of these 
symptoms in one of them have been known 
to come down with the disease within twen- 
ty-four hours of each other. 

The rash first appears on the neck and 
upper part of the chest, spreading from there 
to the face, the lower part of the body, and 
the extremities. The rash reaches its ful- 
ness usually in two or three days after the 
first symptoms of sickness are shown. It 
begins to fade soon after in the order in 
which it comes, and disappears about the 
fifth day, the fever gradually declining as 
the rash fades. Desquamation commences 
about the seventh day, and it is then that 
the danger from contagion is most serious, 
as the scales of the skin contain the germs 
of the disease. The utmost care must 
be taken to prevent the scales from be- 

127 



THE BABY 

ing scattered about the house, carried into 
the street, or out to other homes. These 
germs are very easily carried in the cloth- 
ing and hair of persons coming in contact 
with the patient at this stage. It is at this 
period of the disease that the patient needs 
most careful watching and nursing, as he 
feels, and to all appearances is, fairly 
well ; consequently the nurse is apt to be- 
come less vigilant and observant. In scarlet 
fever it is not the disease itself which is 
so serious as it is the series of ailments 
which are likely to follow, and unless these 
little things are well looked after more se- 
rious consequences will surely be the result. 
The most serious complication which fol- 
lows scarlet fever is kidney disease; through 
the kidneys the heart often may become 
affected, and thus one train of evils follows 
after another. Therefore it is well, as the 
rash disappears, the fever subsides, and 
the patient seems well on the road to con- 
valescence, for the nurse to be most care- 
ful — in fact, double her attentions to her 
patient. It is most important that the ac- 
tion of the kidneys should be looked after, 
the amount of urine passed each day noted, 

128 




PUTTING ON THE BABY S DRESS 



MEASLES AND SCARLET FEVER 

and a semi - weekly or at least a weekly 
analysis made to determine whether albu- 
men is present. These examinations should 
be made after each change of diet, also once 
or twice after the patient is allowed to go 
out; nor should this examination be neg- 
lected in the mildest cases, as it is not un- 
common to have albuminuria develop and 
death follow when a case of scarlet fever 
has been so slight that this precaution was 
not deemed necessary and the patient pro- 
nounced well. 

The first step to be taken in scarlet fever, 
as in other contagious diseases, is prompt 
isolation in a large, well-lighted, and well- 
ventilated room. The room should be on 
a top floor, as far removed from the rest 
of the house as possible, and, if it could 
be so arranged, this floor or part of the 
house should be shut off from the rest. 
Carpets, curtains, pictures, upholstered fur- 
niture, ornaments, etc., should be removed, 
— in fact, anything that cannot be burned, 
washed, or thoroughly fumigated when 
the sickness is over. In order that the 
room may not be utterly bare or desolate, 
strips of old carpet may be laid on the floor, 

9 129 



THE BABY 

and bright pictures from illustrated papers 
or magazines may be pinned on the wall. 
It is best not to use a mattress ; heavy blan- 
kets or comfortables folded and laid on the 
wire mattress make a soft and most com- 
fortable bed to lie on. If this bed proves 
cold, layers of newspapers or heavy brown 
paper placed next to the wire spring, be- 
tween it and the blanket, will overcome 
this difficulty. This kind of bed has a 
great advantage over a mattress, as it is 
cleaner and much more sanitary. 

The temperature of the room should be 
kept at 68°, or as near that as possible (at 
night, 6o° to 65 is warm enough), and the 
air of the room should be frequently changed. 
This can be done without harm to the pa- 
tient by covering him well, even the face, if 
necessary, with a blanket, and opening your 
windows for a short time ; after the windows 
are closed, gradually remove the covering 
as the room warms up. A grate fire adds 
much towards perfect ventilation. The pa- 
tient should have a warm sponge bath night 
and morning, the temperature of this bath 
to be ioo°. After the bath the entire body 
should be rubbed over with a one-per-cent 

130 



MEASLES AND SCARLET FEVER 

carbolized vaseline; this is to prevent the 
scales of skin from scattering about the 
room and is also mildly antiseptic. As 
the throat is usually more or less sore, it 
would be well to spray it at least twice a 
day with a mild antiseptic solution, such 
as a little borax and water or saturated so- 
lution of boracic acid. With either of these 
solutions mix a little glycerine in propor- 
tion of about one part glycerine to nine- 
teen parts of the solution. If the patienl 
is old enough to know how to gargle, let 
him frequently gargle the throat with cold 
water, as it will cool and soothe the inflamed 
parts; or a small piece of ice may be held 
in the mouth occasionally. Water to drink 
should be given freely, especially if there 
is any suspicion of kidney trouble. The 
nose should be kept clean by means of a 
small cotton swab, and the mouth washed 
several times a day with a piece of soft linen 
or absorbent cotton. Throw these bits of 
cotton or linen in the fire as soon as used ; 
if there is no open fire or stove in the room, 
keep small boxes or paper bags for this pur- 
pose, and have these receptacles sent to the 
furnace for cremation. 

131 



THE BABY 

The nurse should watch carefully for 
signs of earache or purulent discharges 
from the ear. In case of such the ear should 
be syringed three or four times a day with 
hot bichloride of mercury, one to five thou- 
sand, or the boracic acid above mentioned, 
as proper attention paid to ear trouble 
in its early stages may be the means of 
saving the child from deafness later. 

The patient's diet, for at least three weeks, 
should be of milk and nothing else; this 
because of the tendency to kidney trouble. 
If there be no signs of such complication, 
the milk diet can be followed by toast and 
light food ; make the change of diet slowly, 
however, and under the physician's advice. 
Dishes used in the sick-room should be 
washed and boiled before sending back to 
the kitchen, and after boiling they must not 
be kept standing in the room, but placed 
outside of the door, to be removed as, soon 
as possible. 

The period of desquamation is usually 
about five weeks, but is sometimes prolonged 
until the seventh or eighth week; the pa- 
tient should be carefully examined from 
head to foot, especially between the fingers 

132 



MEASLES AND SCARLET FEVER 

and toes, before being allowed to leave 
the sick-room. Desquamation commences 
with fine scales, and is usually seen first 
about the roots of the hair or the rim of the 
ear. This shedding of the skin soon be- 
comes general, the scales are much larger, 
often coming from the body in good-sized 
shreds, the skin from the finger often com- 
ing off entire like the finger of a glove. 

The sick-room should be swept twice a 
day, and the sweepings immediately burned 
or placed in the box or paper bag before 
mentioned; after sweeping, the wood- work, 
furniture, etc., in the room should be wiped 
off thoroughly with a damp cloth wrung 
out of bichloride of mercury, one part to 
five thousand parts of water, or carbolic 
acid, one to forty. 

The nurse should be provided with rubber 
gloves to protect her hands during this 
process. She should also wear always a 
mob-cap to prevent the germs from getting 
into the hair, and should never be without 
it while in the sick-room. As it is quite 
necessary that the nurse should have some 
exercise in the fresh air, clothes worn in 
the sick-room should be removed, even to 

133 



THE BABY 

the shoes, and left in that apartment. 
The nurse can step outside the sick-room, 
either into a smaller one or a portion of 
the hall screened off, and there put on the 
clothing to be worn outside. She may then 
go out with comparatively little danger of 
carrying the disease, but it is better that 
she should not go into other rooms or parts 
of the house. It may be well to mention 
that all clothing worn in the sick-room 
should be made of cotton material and wash- 
able. All clothing and bedding from pa- 
tient and nurse which is to go to the 
laundry should be soaked overnight in a 
solution of carbolic, one to sixty, then 
placed in a bag which has been wrung out 
of the same solution, and the bag lowered 
from the window to the ground below, where 
it is taken by the laundress and placed in 
a boiler and boiled for half an hour before 
washing. The clothing can then be safely 
handled without the slightest danger of 
infection. If a nurse is careful and con- 
scientious in carrying out these directions, 
there is very little danger of the germ- 
laden scales being scattered. If, at the 
end of five weeks, the patient, after care- 

134 



MEASLES AND SCARLET FEVER 

ful inspection, shows no signs of scaling, 
he may be released from the sick-room, and, 
in a few days, if the weather is mild, be al- 
lowed to go out for a little while, but if the 
skin is still peeling the isolation must be 
kept up for another week, or still longer, 
until it has entirely ceased. 

Before leaving the sick-room the patient 
must have a bichloride bath from head to 
foot; this is to be followed by a thorough 
soap - and - water bath. Then, wrapped in 
a clean blanket, he is carried into another 
room, dried and dressed. The nurse her- 
self should then go through the same per- 
formance. Next come the fumigation and 
cleansing of the room. The first step is to 
stop up all cracks and crevices in the room 
with cotton; papers should be pasted over 
registers, fireplaces, or any other outlet 
where the fumes of the disinfectant used 
might escape. The substance to be used for 
fumigation being lighted, leave the room, 
stopping up cracks and key-hole of door 
from the outside. The room should not 
be disturbed for twenty-four hours; then 
it may be opened and thoroughly aired. 
Things in the room, such as toys, books / 

135 



THE BABY 

papers, bits of carpet, etc., would best be 
burned. The room should then have a 
thorough cleaning. Floor, wood-work, and 
furniture should be well washed, also the 
walls — that is, if they are painted or of 
hard finish ; but if the room is papered, the 
paper should be taken from the walls, or 
rubbed down with bread, as this is excel- 
lent to catch germs and small particles of 
dust. The ceilings should be rekalsomined. 

In all cases of scarlet fever, whether 
mild, moderate, or malignant, the same 
precautions should be taken. Not one 
of the above is to be omitted or slighted, 
as it is chiefly through imperfect precau- 
tions and carelessness, or in allowing the 
patient to leave the sick-room before he 
should, that scarlet fever is spread in fam- 
ilies, schools, institutions, and neighbor- 
hoods, thus causing epidemics. 

Note also the precautions mentioned in 
measles as to the care to be exercised in 
the use of disinfectants. 



CHAPTER VIII 

DIPHTHERIA, WHOOPING-COUGH, MUMPS, 
AND CHICKEN-POX 

ONE custom which should be established 
in every household where there are 
children is that of looking into a child's 
throat; this should be done once or twice 
every week, and, if an epidemic is raging, I 
would advise doing so once a day. If this 
practice is established early in life, the child 
soon becomes accustomed to it, and, after 
it has been done two or three times, will 
not make the slightest objection to it. It 
is only when the unusual occurs that 
children are frightened and rebel. In the 
hospital, where the children's throats are 
examined almost every day, there is never 
an outcry ; in fact, when the nurse is 
seen approaching with the tongue-depresser 
used for the purpose there is a scamper 
towards her, each child clamoring for the 

137 



THE BABY 

honor of being looked at first. To ob- 
tain a satisfactory look at an infant's throat 
it is necessary that the child should be held 
with its back pressed closely against the 
chest of the person holding him and directly 
in front of the person who is to examine 
the throat. The examination should be 
made in front of the window, but not in 
the direct rays of the sun. An older child 
need not be held, but will stand on a chair 
or stool for his throat to be looked at. If 
it is necessary to examine the throat at 
night, a candle can be held by a third per- 
son, and by placing the bowl of a bright 
silver tablespoon behind the flame the light 
can be reflected down the throat. A look 
at the throat by daylight, however, is far 
more satisfactory. The handle of a tea- 
spoon is best to make the examination 
with; place it far back in the mouth, then 
firmly depress the tongue; it is thus the 
work of but a few seconds to get a most 
satisfactory look at the entire throat. 

Diphtheria is confined to no particular 
season of the year, but seems to be more 
prevalent in damp weather. The mem- 
brane of this disease is rarely seen in small, 

138 



DIPHTHERIA 

separate patches, but in one continuous 
patch or membrane on one or both sides 
of the throat; sometimes it is seen only 
on the uvula, and again spreading, it cov- 
ers the entire throat in a continuous irreg- 
ular membrane. When seen at the earliest 
stages of the disease, the membrane is very 
harmless-looking, resembling somewhat a 
thread of cobweb, or a particle of milk which 
has not been swallowed, but has remained 
in a little gray streak across the tonsil. 
This patch does not, however, disappear 
on swabbing, and soon assumes a dirty 
yellowish appearance; the tissue about it 
is reddened, and the throat bleeds easily 
when swabbed. 

Diphtheria, unfortunately, is not entirely 
confined to the throat, but is very common 
in the nose, where it is difficult, if not im- 
possible, to see the membrane, and thus 
the disease often gains a firm hold on the 
patient before it spreads to the throat, where 
it is discovered. Nasal diphtheria is char- 
acterized by a profuse nasal discharge, 
which is freely streaked with blood; in 
fact, slight but frequent hemorrhages from 
the nose are always suspicious. When 

139 



THE BABY 

this symptom is present, do not hesitate 
one moment, though the throat be free 
from any sign of the disease, but send for 
a physician and have an examination 
made at once of the nasal discharge, in 
order to determine the presence or absence 
of diphtheria bacilli. Other signs to be 
taken into serious consideration, when even 
patches and nasal discharges are absent, 
are hoarseness and loss of voice, also swell- 
ing of the throat; the former are often 
the first signs of membranous croup, which 
is nothing more nor less than diphtheria, 
the membrane being so far down the throat 
as not to be seen, but filling the wind- 
pipe, and the disease, therefore, often is not 
discovered until it is too late to help the 
child. The following are the five impor- 
tant symptoms to be observed : hoarseness, 
loss of voice, swelling of the throat, nasal 
discharge, and character of patch on throat. 
The temperature is usually from ioo° to 
102°; the throat is not so very sore, but 
the patient complains of throatache. The 
fever is not apt to run as high or the throat 
to be as sore as in a simple case of ton- 
silitis. When any of these symptoms pre- 

140 



DIPHTHERIA 

sents itself, it is time to act, and quickly. 
It is to be most earnestly hoped that the 
physician consulted is a firm believer in 
antitoxin, for, having had under observa- 
tion and nursed very many cases, I find 
there is simply no comparison with the 
results before and since the use of this 
wonderful discovery. Before its use, one 
case breaking out in an institution meant 
most distressing results; but with this 
remedy at hand, both for the patient and 
those exposed, diphtheria is one of the 
least to be dreaded of the contagious dis- 
eases. It must be given, however, at the 
very outset, and in a large quantity, to 
have the desired effect; to wait until the 
last moment, when the entire system is com- 
pletely poisoned with the disease, and then 
give it, is worse than useless. The germs 
by which the disease is contracted usually 
enter the system through the mouth, thus 
making a very good argument against 
children using the same spoon or fork, 
and drinking from the same cup, as is the 
habit in schools, institutions, and public 
places; the kissing habit should also be 
strictly prohibited. The germs of this dis- 

141 



THE BABY 

ease are not believed to be carried in 
the breath of one having the disease, but 
are carried through mucous discharges of 
nose, mouth, and throat, which are found 
to be full of them; open wounds, scratches, 
and cuts coming in contact with this mu- 
cus will often become infected, and a serious 
attack of the disease follow. The diph- 
theria bacilli are sometimes found in nose 
and throat long before the patient shows 
any symptoms of the disease. The period 
of incubation in diphtheria is usually from 
two to four days, but often, where condi- 
tions are favorable for the growth of the 
germs, it has been found to develop in a 
much shorter time. These conditions are 
found in close, poorly ventilated apart- 
ments and sleeping-rooms, also where there 
is defective drainage. Delicate children 
or those with sensitive throats are almost 
sure to contract the disease in such sur- 
roundings. These conditions are not only 
confined to the tenement-houses, close and 
poorly ventilated rooms, but are only too 
often found in the houses of the richer 
classes. That the disease flourishes and 
spreads in such environments should alone 

142 



DIPHTHERIA 

be a plea for plenty of fresh air for chil- 
dren, as it is also a well-known fact that 
these bacilli will not develop or grow in 
the direct rays of the sun, while impure 
air affords food for them on which they 
grow and multiply rapidly. That chil- 
dren with delicate throats are fit subjects 
for this disease also shows the necessity 
for having any throat obstruction, such 
as enlarged tonsils or adenoid growths, 
removed as early as possible, as they keep 
up a constant irritation, causing the throat 
to become weakened and over-sensitive. 
Under ordinary and favorable conditions, 
without the use of antitoxin, the membrane 
of diphtheria loosens and commences to 
break away from the throat at about the 
end of a week, but in cases of unusual sever- 
ity this does not occur sometimes for two 
or even three weeks. With antitoxin, how- 
ever, if it is used at the outset, the mem- 
brane will commence to loosen within twen- 
ty-four hours, and will often entirely dis- 
appear in forty-eight hours; it also pre- 
vents the membrane from growing and 
extending. When a case is unusually se- 
vere it may be necessary to give an in- 

143 



THE BABY 

jection of this remedy several days in suc- 
cession. After the throat is clear of mem- 
brane, it will, for some days, continue to 
be a bright red, and will bleed easily when 
touched. When a patch is discovered in 
a child's throat, or any of the above symp- 
toms appear, it is always best to isolate 
the patient at once, and in all cases, no 
matter how mild the symptom, a culture 
should be taken, and a microscopical ex- 
amination made to determine whether diph- 
theria bacilli are present. 

In cases of diphtheria strictest isolation 
is desirable, and to prevent the spread of the 
disease every child known to have come in 
contact with the diseased child, the mem- 
bers of the family, and the person who is to 
nurse the patient should have an immuniz- 
ing injection of antitoxin. This treatment 
will be found as effectual in preventing 
the disease from spreading as has been 
the use of vaccine in checking small- pox; 
it does not, however, immune the subject 
for as long a time, the effects of this anti- 
dote passing off in a few weeks after it is 
given. A serious complication arising from 
this disease is pneumonia, which is most 

144 



DIPHTHERIA 

likely to occur while the disease is at its 
height. Paralysis also sometimes follows 
severe cases. The most common compli- 
cation, though, is anaemia, which is a de- 
ficiency of the red-blood cells; this causes 
a weak heart action, and is frequently 
followed by heart disease. It is well dur- 
ing the entire course of the disease, and for 
some time after, to give iron. During the 
acute stages a fluid form is best to use, 
for, besides supplying the desired element 
to the blood, it is a good antiseptic for the 
throat; but it should be taken slowly and 
through a glass tube. A soda - bicarbo- 
nate mouth-wash should also be used after 
taking it. This is to prevent the drug 
from harming the teeth. Iron, though, 
should be given only as the doctor pre- 
scribes, as there are cases where the stom- 
ach will not retain it. It is doubtful if 
swabbing the throat is as beneficial as it 
was once thought to be, for the throat is 
extremely tender at this time, and swab- 
bing adds to the irritation, often causing 
a raw surface on which the bacilli feed. 
Gentle swabbing is often necessary, how- 
ever, to remove the loosened membrane, 

145 



THE BABY 

and also in the cases of infants who can- 
not gargle ; in these latter cases, to gently 
press the affected part with a soft swab 
which has been dipped in a mild antisep- 
tic is quite enough. Gargling is a far 
better method of disinfecting the throat. 
With children the gargle should be mildly 
antiseptic, so that no harm will be done 
if some be swallowed. There is no better 
way of caring for the throat of a child dur- 
ing this disease than to syringe it once 
every two hours with a solution of salt and 
water; proportion, one teaspoonful of salt 
to one full pint of water, and boiled for 
twenty minutes; this solution should be 
as hot as no° to 112 when used. The 
syringe should have a long neck or noz- 
zle, so as to reach far back in the mouth. 
Place it in one side of the mouth, tilt the 
head slightly forward and towards the op- 
posite side, then syringe, and the water 
will come out the other side; have a 
basin ready to catch it. If there is a pro- 
fuse nasal discharge, it will be necessary 
to syringe the nose two or three times a day; 
otherwise it would best be omitted, as it is 
a somewhat painful and irritating opera- 

146 



DIPHTHERIA 

tion. Pieces of soft linen or cotton cloth 
should be used for cleansing both nose and 
mouth, and then burned immediately. The 
same precautions should be taken in pre- 
paring soiled clothing for the wash and in 
washing as are described for scarlet fever. 
Mucus from nose and mouth, even saliva 
which may drivel from the mouth, should 
not be allowed to remain on bed-linen or 
clothing for a moment, but as soon as it 
is seen should be immediately washed off 
with a cloth wet with a strong disinfectant, 
or the garment or bed-clothing soaked in 
a solution of carbolic acid, one to sixty. 
The same precautions should be taken 
by the nurse about her clothing worn in 
the sick-room as in measles or scarlet fever. 
She ought also to keep a gargle for her 
own use, and use it freely. 

It is most necessary that a patient suffer- 
ing with this disease should be stimulated 
freely during the illness, in order that the 
heart action be strengthened. That the 
nourishment be kept up is also important. 
It is well to partially peptonize an infant's 
food, in order that a certain amount of 
food be retained and absorbed by the stom- 

147 



THE BABY 

ach. A nursing baby should not be put to 
the breast, but the milk pumped out at 
regular intervals and given the child. 
With older children the strength should 
be kept up by a careful and nourishing 
diet. The patient should be kept in bed 
during the entire active stage, and for at 
least a week or ten days after the mem- 
brane has entirely disappeared; this on ac- 
count of the tendency to heart failure. On 
this account also no excitement or violent 
exertion should be allowed for some time 
after the patient is able to be about. Cult- 
ures ought to be taken from the throat 
two or three times a week after the mem- 
brane is gone, and the patient should not 
be allowed to leave the room until the ba- 
cilli have entirely disappeared. This cult- 
ure should be taken in the morning before 
the throat has been gargled or the mouth 
washed. 

When the doctor pronounces it safe for 
the patient to leave the sick-room, the room 
must be tightly sealed and f umigated. Open 
the room at the end of twenty - four hours, 
have it well aired and sunned for another 
day, then give it a good sweeping and 

148 



WHOOPING-COUGH 

cleaning, books, toys, etc., used by the pa- 
tient while ill being burned. It is not nec- 
essary to exercise the extreme measures 
advised with scarlet fever as regards fur- 
niture, walls, etc. 

WHOOPING-COUGH 

Whooping-cough is a disease which is 
almost, if not quite, as contagious as mea- 
sles. The period of incubation is from six 
to fourteen days; if after sixteen days 
from the time of exposure the disease does 
not develop, the probabilities are that it will 
not. Children under one year are especially 
susceptible to it, and it is not infrequent 
to find babies of only a few weeks suffering 
from this disease. In older children the 
danger of any serious outcome is slight, 
but babies should be carefully guarded 
against exposure, as the mortality among 
infants from this disease is large, few being 
strong enough to withstand it. Whoop- 
ing-cough is one of the most trying of the 
contagious group, owing to the duration 
of the disease, which covers a period of 
from three to four months. During the 

149 



THE BABY 

greater part of this time it is not safe for 
the patient to mingle with other children. 
This means isolation for the child for at 
least from seven to ten weeks, some phy- 
sicians claiming that unless the case is un- 
usually severe it is not infectious after 
that period. 

It is almost impossible in the early stages 
of whooping-cough to make a diagnosis, 
as at the outset the cough is in no way 
distinguishable from other ordinary coughs ; 
the symptoms are at first slight fever and 
cough; the latter, instead of subsiding at 
the end of six or seven days, as an ordinary 
cough should, begins to increase, the cough 
soon coming in the form of paroxysms. 
During these efforts there is much red- 
ness of face. The paroxysms generally 
increase in violence, and are accompanied 
by the raising of quantities of tenacious 
mucus from the throat, and by vomiting. 
There is also a deep inspiration or draw- 
ing in of the breath and holding it, thus 
causing a peculiar noise which is called 
the whoop, and is most distressing. The 
inspiration and whoop are spasmodic, and 
cannot be controlled, and it is often some 

150 



WHOOPING-COUGH 

moments before the patient can catch his 
breath again. With the infant the whoop 
is often entirely absent, and not heard dur- 
ing the entire course of the disease, but it 
is the paroxysms, redness of the face, and 
vomiting which make the diagnosis cer- 
tain. Putting a spoon - handle far back 
into the mouth and depressing the tongue 
and holding it there for a moment, while 
not a positive test, often proves valuable 
in helping to diagnose a case in the early 
stages of the disease before the whoop has 
developed; it is also of value as a test in 
infants who do not whoop, as it will bring 
on the paroxysm with the vomiting and 
redness of face; try this test several times, 
and if each time it brings on the paroxysm, 
one may feel pretty sure that the child has 
something more than an ordinary cough. 

The average duration of the acute or 
spasmodic stage is from four to five weeks ; 
after this the violence of the spasms dimin- 
ishes, although in some cases of unusual 
severity, or where fresh cold has been con- 
tracted, the duration of the acute stage is 
much longer. 

One complication of whooping-cough is 
151 



THE BABY 

pneumonia, and it is this which makes 
the disease so dangerous in infants. This 
complication occurs most frequently during 
the winter months, while in summer di- 
arrhoea is the more frequent complication. 

It is doubtful if medicine is of much 
value in whooping-cough. There are one 
or two drugs which are occasionally given 
to control the spasm when it is unusually 
severe, but they must be given only under 
the direction of the physician. As a rule, 
expectorants and medicine do more harm 
than good; they upset the stomach, espe- 
cially that of an infant, and the stomach, 
above all, should be kept in good condition, 
as it is upon the strength derived from its 
nourishment that the baby has to rely to 
carry it through the siege. The thing 
which has been found to give the most re- 
lief is the inhalation of plain or medicat- 
ed steam. This may be accomplished by 
means of an ordinary inhaler or a kettle 
which is kept boiling in the room at cer- 
tain intervals, the child thus inhaling the 
moisture-laden air. A piece of absorbent 
cotton or sponge may be placed in the 
spout of the kettle, on which has been 

152 



WHOOPING-COUGH 

placed the medication; the steam passing 
through the cotton or sponge permeates 
the room with medicated vapor. Creosote 
and cresoline are considered the best sub- 
stances to use for this purpose, a solution 
of either placed in a dish and vaporized 
over an alcohol-lamp making a good sub- 
stitute for the croup -kettle. Cloths wrung 
out in one of these solutions and hung up 
in the sick-room are often helpful. The 
very best remedy for whooping-cough, how- 
ever, is fresh air. In pleasant weather let 
the patient be kept out - of - doors from 
morning until night if possible, and you 
will find that the child will have fewer 
paroxysms and less violent ones than when 
shut up in the house. This is rather hard 
on other children of the neighborhood 
who spend much time out-of-doors, as they 
are likely to become exposed and catch 
the disease; but the right and only thing 
to do under these circumstances is for the 
mother to be most careful in warning other 
mothers and nurses of the danger, and to 
be most conscientious in her efforts to keep 
her child away from others. As the dis- 
ease is not supposed to be infectious ex- 

153 



THE BABY 

cept during the spasms of coughing, the 
mother or nurse will be wise, when she 
hears a child with this cough, no matter 
if the child be at some distance, to cover 
the head of her own child or charge with 
a handkerchief, dress skirt, or anything 
else that is at hand. The nose and mouth 
especially should be protected. Hurry the 
child out of harm's way as quickly as pos- 
sible. Prompt action at such times will 
often prevent a child from catching the 
disease. 

The nursery should have plenty of fresh 
air at night, but care should be taken to 
protect the child from draughts with a 
screen. When the cough comes on with 
an infant it should be held forward 
with face downward; in this position the 
mucus is more easily expelled, and when 
this is gotten rid of the paroxysm usu- 
ally ceases. Older children invariably help 
themselves by either running to older per- 
sons and catching hold of them, grasp- 
ing a chair for support, or sometimes run- 
ning into a corner, bending over, and press- 
ing the head against the wall, thus seeking 
relief . At first these attacks will frighten 

154 



WHOOPING-COUGH 

the child, and this will probably be followed 
by a spell of crying. A basin should be 
kept constantly at hand, as vomiting comes 
with almost every attack during the early 
stages. 

In most contagious diseases it is most 
desirable to keep the patient isolated in 
one room, but this is not necessary with 
whooping-cough; in fact, the child should 
have as much change as possible, and be 
allowed the freedom of the house. If the 
cough hangs on for a long while a com- 
plete change of air is often necessary to 
break it up, the sea-shore being especially 
beneficial. 

The diet needs somewhat careful atten- 
tion, as it is necessary that the child's 
strength be kept up. The regular hours 
of feeding will have to be somewhat broken 
in upon; if, for instance, an infant is con- 
stantly losing its food with a cough, es- 
pecially soon after it has been taken, it is 
quite certain that the patient does not 
derive much benefit or nourishment from 
that meal, consequently another and lighter 
meal should be given ten or fifteen min- 
utes after the coughing has ceased. It may 

155 



THE BABY 

become necessary for a while to peptonize 
the food of the infant in order that it may 
be more easily assimilated. With children 
up to two years of age the diet should be 
fluid, and even for older ones, while the 
disease is at its height, the food, while it 
should be nourishing, should not be too 
heavy. 

After whooping-cough no especial fumi- 
gation or disinfecting is necessary. Dur- 
ing the disease the progess of systematic 
and thorough airing of the room every day 
is quite necessary; this, with the use of the 
disinfectants mentioned, is all the precau- 
tion necessary. 

MUMPS 

Mumps is probably one of the least in- 
fectious of the contagious diseases. It is 
usually contracted by direct contact, but has 
been known to be carried in clothing and by 
a third person. The period of incubation is 
From two to three weeks, although occasion- 
ally it will develop earlier; the germs of 
the disease are probably taken into the sys- 
tem by means of the salivary glands. The 
symptoms are, first, pain in the parotid 

156 



MUMPS 

gland, which is a conglomerate mass ly- 
ing just below the lobe of the ear. The 
pain is followed by swelling of the gland; 
this swelling is distinguishable in the fact 
that it has its centre just below the ear, 
and is usually distributed alike on both 
sides of this organ, and is never confined 
to one side of the ear only. There is con- 
siderable pain on moving the jaw, and 
mastication is difficult. Acids taken into 
the mouth will usually produce pain. The 
secretions of saliva are somewhat dimin- 
ished, in older children often painfully 
so. Occasionally both sides become af- 
fected at the same time, but usually the 
left side first, the right side following in 
a few days; it sometimes happens, how- 
ever, that the second side does not become 
affected for two or three weeks or even 
longer after the appearance of the first 
symptoms. The swelling lasts about a 
week, sometimes in light cases a little less ; 
but it is necessary that the patient should 
not come in contact with other children for 
three weeks after the swelling has sub- 
sided, as up to that time there is danger 
of communicating the disease to others. 

157 



THE BABY 

It is a disease which is generally unattend- 
ed with serious consequences, fatal cases 
being almost unknown. The severest cases 
usually occur among large children, thir- 
teen or fourteen years old. Infants are 
not susceptible to the disease, cases under 
four rarely developing ; but from that age 
up to fourteen years it is most common. 
The treatment of mumps is simple. The 
patient may be kept in bed a few days if 
there is fever. A mild antiseptic mouth- 
wash should be used several times a day. 
It is most necessary that the mouth should 
be kept clean, as, the patient finding it diffi- 
cult to swallow, particles of food are likely 
to remain in the mouth, where they decom- 
pose. To relieve the pain, bind on a piece 
of flannel which has been heated and keep 
the affected parts warm, as moderate heat 
affords the patient great relief. A thick 
layer of cotton is often quite sufficient. 
The diet, while the swelling lasts or while 
there is fever, should consist of broths and 
milk ; solid food may be taken as soon as 
it can be masticated without discomfort to 
the patient. It is not considered necessary 
to fumigate after this disease. 

158 



CHICKEN-POX 



CHICKEN-POX 



Chicken-pox is a mild disease, and, though 
it is highly contagious, it is doubtful if 
any serious consequences follow. The pe- 
riod of incubation is from ten to fourteen 
days, and in a few cases even longer. The 
disease is contracted by contact, and also 
may be carried by a third person. It is 
most often found in infants from six months 
to a year old, but is common in childhood up 
to the age of five or six years. After that 
age the disease is less frequently seen. It 
occurs at no particular season, but comes 
at all periods of the year with equal fre- 
quency. Occasionally some indisposition 
and fever precede the disease, but the ap- 
pearance of the rash is usually the first 
sign or intimation of trouble. The rash 
appears first in the form of small, red pap- 
ules, irregularly scattered over the body; 
these in a very short time form a vesicle, 
which contains a clear serum or watery 
fluid. These vesicles, also, are found often 
on the mucous membrane of the mouth. 
On the body the skin about these vesicles 
is slightly reddened; they are not deep, 

159 



THE BABY 

but usually confined to the outer layer of 
the skin. The vesicles in turn dry out 
and form a crust. The rash appears in 
successive crops, and so rapid is the process 
from the papular to the dry or crusty stage 
that the rash can be seen in all these three 
degrees at one time upon the body. As the 
vesicle commences to dry a small, dark 
speck appears in the centre of the spot; 
this is a marked characteristic of the dis- 
ease, and valuable in diagnosis. The du- 
ration of the trouble is from ten days 
to two weeks in mild cases, but may last 
as long as a month or even longer when 
the disease is more severe. The temper- 
ature is quite irregular, but never very 
high. While the disease is not a danger- 
ous one, it is best not to unnecessarily 
expose others and allow it to spread. The 
child suffering from chicken-pox should not 
be allowed to come in contact with other 
children outside its own family, and it is 
even better that it should be isolated in 
its home if there are other children. The 
child should be watched and not allowed 
to scratch these vesicles, as there is dan- 
ger of poison from the finger-nails, which 

160 



CHICKEN-POX 

would make a more deep-seated ulcer — one 
that would burrow into the flesh, and, when 
healed, would leave a scar. The finger- 
nails will also carry the serum contained 
in these vesicles to other parts of the body, 
reinfecting it, and thus spreading and con- 
tinuing the duration of the disease. The 
body should be bathed every day; if the 
case is severe, sponge the infected parts 
with a mild disinfecting wash, or rub on 
carbolized vaseline. If the disease is dis- 
covered at an early stage, and when there 
are only a few papules on the body, much 
may be done towards preventing the child's 
reinfecting itself and spreading the disease 
by dusting these spots with boracic-acid 
powder, and then covering with a little 
flexible collodion or small squares of isin- 
glass plaster. I have known this treat- 
ment to prove quite effectual. If there is 
fever, the diet of the patient should be 
fluid, or very light, until after the fever is 
past. This disease needs no special medica- 
tion or treatment other than that described. 
Fumigation is not necessary, but is a good 
thing on general principles. 
« 161 



CHAPTER IX 

EMERGENCIES 

TN a family where there are little chil- 
■*• dren emergencies often arise in which it 
is necessary to act quickly — in fact, upon 
the moment. At these times, by intelligent 
aid or interference, much can be done to 
give relief, a life even may be saved before 
a doctor can get there. Many simple ail- 
ments of children may be safely treated, 
and many emergencies met by a clear- 
headed mother when a doctor is not at 
hand. The "little knowledge" which is 
proverbially "a dangerous thing" is quite 
the reverse if wisely used in such cases. 
Take the case of a child with an attack of 
croup, for example. With most children 
this attack comes on very suddenly, usu- 
ally in the night. In many cases it is a 
serious matter, and immediate action is 
imperative. It is not always possible to 

162 



EMERGENCIES 

have a doctor at a moment's notice, espe- 
cially at night, and every mother should 
know how to act at once, and know not 
only one, but a half-dozen remedies. j 

Croup. — The cough which comes with 
croup is one never to be forgotten, and 
is so different from the ordinary cough 
that, once heard, it is recognized almost 
immediately. It is a harsh, barking cough, 
with a metallic ring. The respirations be- 
come labored and slow, and the air, as it 
comes through the trachea, often makes 
a whistling sound caused by the child's 
struggle for breath. No time should be 
lost in attempting to relieve the sufferer. 
When there are young children it is well to 
put ipecac on the nursery medicine-list, to 
be used in this emergency; fifteen drops 
may be given every fifteen or twenty min- 
utes, until the child vomits. If, after four 
or five doses, vomiting does not take place, 
it is unnecessary to give more. Other meth- 
ods must then be tried to induce vomiting 
to relieve the child, the object being to 
force up in this way the tenacious mucus 
which has lodged in the throat and is inter- 
fering with breathing. Warm mustard and 

163 



THE BABY 

water is often successful, or, by running 
the finger down the throat one can often 
dislodge a quantity of the tough substance 
that is distressing the child. In the mean 
time, sponges or cloths wrung out of very 
hot water may be placed upon the throat 
just below what is called the "Adam's 
apple." The inhalation of steam is a 
most important thing in the treatment of 
croup, and, usually, will give more and 
quicker relief than anything else. While 
the first - mentioned remedies are being 
tried, have another member of the family 
at work to procure steam, either by put- 
ting a tea-kettle on the kitchen fire, if there 
happens to be one, or by heating water 
over an alcohol-lamp or gas or oil stove. It 
is best to put only a little water in the ket- 
tle, in order that it may boil quickly. Con- 
struct a large funnel of stiff brown paper, or 
even of newspaper, and have this improvised 
funnel lead from the spout of the kettle 
to the child's mouth and nose, and let him 
inhale the moisture. Another way is to 
put a sheet over a small crib and let the 
child lie in this tent inhaling the steam, 
for hours at a time, if necessary, only oc- 

164 




LOOKING DOWN THE BABY'S THROAT 



EMERGENCIES 

casionally lifting a corner of the tent for 
a little air. This treatment is most ef- 
fectual even in very severe cases of croup, 
and can be kept up for twenty-four hours, 
or longer if necessary, without the slight- 
est injury to the patient, but greatly to 
his relief. All this can be done to help the 
child until the doctor arrives. 

Colic. — Colic in young infants is com- 
mon as well as distressing. The remedy 
is very simple, and its cure may always 
be effected without the use of alcohol or 
drugs. Colic is most commonly caused by 
one of two things : indigestion or cold. The 
symptoms are rather violent paroxysms of 
crying, legs are drawn up on the abdomen, 
and the extremities are usually cold. As a 
preventive, assist the circulation and also 
the digestion by keeping hands and feet 
warm. Do not give a baby whiskey, fen- 
nel, or other herb teas; it is only be- 
cause these drinks are given hot that they 
help the trouble at all ; plain hot water will 
give just as much relief, and will not upset 
the stomach. The water must be given 
very hot, and by a dropper, two or three 
teaspoonf uls at a time ; try a few drops on 

165 



THE BABY 

your own tongue first in order not to scald 
the baby's mouth. Often simply warming 
the hands and feet in front of an open fire, 
or laying the baby across your knee on his 
stomach, with your warm hand under it and 
gently patting the back, will be all that is 
necessary for a cure. A hot-water bag laid 
upon the stomach is also good. If the at- 
tack be a very hard and stubborn one, a 
few drops of essence of peppermint may be 
added to a wine-glass of hot water and a 
few drops of the mixture given to the child ; 
or a bit of soda-mint can be given with usu- 
ally good effect. 

Earache. — This is another common ail- 
ment of babies ; they often suffer much, and 
are frequently treated for other troubles be- 
fore the real one is discovered. A child with 
an earache will awaken suddenly from a 
sound sleep with a sharp cry, and usually 
put his hand to his ear; after a short crying 
spell he quiets down or falls asleep, only 
to waken again later with another par- 
oxysm. Heat of any kind applied to the 
ear will almost always give relief, but, if 
it does not, the doctor should be called. A 
small hot-water bag placed against the 

166 



EMERGENCIES 

ear, or small muslin bags filled with hops, 
bran, or salt — in fact, anything which will 
retain the heat — heated in the oven and 
applied to the ear, will usually relieve the 
pain. If the attack occurs at night, it is 
not always convenient to procure one of 
these things; then the warm hand placed 
over the ear will afford some help; a flan- 
nel is still better, whether it be the baby's 
band, his shirt, or his petticoat; it can be 
heated very quickly by holding it against 
the gas-shade, or, better yet, the chimney 
of the lamp. If a little hot water can be 
had, syringe the ear with it, temperature 
no° to 115 ; then apply the hot flannel. 




SOFT RUBBER EAR SYRINGE 



Continual or frequent attacks of earache 
should be treated only by a physician. 
Nose-bleed. — Hemorrhage from the nose 
167 



THE BABY 

occurs frequently among children, ner- 
vous and excitable children being more 
liable to it than are others. These attacks 
will often happen several times a day for 
three or four days. In such case the child 
should be put to bed and kept as quiet 
as possible; if after several days there is 
no recurrence, he may be allowed to get 
up, but should be kept from excitement 
or hard play of any kind. The ordinary 
nose-bleed, of which many children have 
occasional attacks, may be controlled by 
placing a small bit of ice, wrapped in a 
soft cloth or piece of absorbent cotton, 
across the bridge of the nose; cold appli- 
cations at the back of the neck, pinching 
the nose, pressure on upper lip just be- 
neath the nostrils, stuffing cotton or soft 
tissue-paper under the upper lip, sitting 
in a semi-upright position with the hands 
kept above the head, are all simple means 
by which nose-bleed is controlled. 

Swallowing of Foreign Substances. — Chil- 
dren who creep or run about the room are 
constantly picking from the floor, table, 
or chairs little articles such as buttons, 
beads, bits of broken crockery or glass, 

168 



EMERGENCIES 

sometimes a coin, and swallowing them. 
They have also been known to swallow small 
pieces of jewelry, which were intended to 
adorn their persons rather than to clog 
their little stomachs — tiny lockets, chains, 
finger - rings, etc. The preventive is the 
first thing to be considered, and care 
should be taken to leave none of these 
small temptations about, such as jewelry, 
pins, needles, and, above all, an open 
safety-pin should never be within the 
reach of a little child. It is the habit of 
many mothers and nurses, when dressing 
or changing a child, to stick the safety- 
pin in the pillow, bedding, or upon the per- 
son, unclasped ; the attention may be called 
off, perhaps, for only a few seconds; it is 
but the work of an instant only for the child 
to grasp the pin and put it into his mouth. 
Nothing is more difficult to extricate from 
the throat than an open safety-pin; it is 
almost impossible without an operation, 
and in many cases even this does not avail. 
If a particle of food or some other object 
lodges in the child's throat and cannot be 
removed by the fingers, and the child be- 
comes blue from choking, measures must 

169 



THE BABY 

be taken for instant relief. A sharp blow 
between the shoulders, or turning the child 
upside-down by holding him b} 7 - the feet, 
and administering several sharp slaps on 
the back, may force it out. If neither is 
effectual, run the finger down the throat 
on the right side as far as it will go; some- 
times one reaches beyond the obstruction, 
and, by curving the finger, can dislodge it ; 
in the mean time send for the doctor as quick- 
ly as possible. If the foreign body swal- 
lowed passes down out of sight, it will prob- 
ably reach the stomach safely, and there 
is no need for alarm. Do not, however, 
make the common mistake of giving the 
child a cathartic in order to hurry the ob- 
ject along through the intestines; this is 
wholly wrong. The result is that all the 
substance in the intestines becomes thin 
and watery, rushes on past the obstruction, 
leaving it to find, perhaps, a lodging-place 
for itself in one of the turns or twists of the 
intestines, and there it remains to set up an 
irritation and inflammation. The proper 
thing to do is to give the child solid food — 
mush, bread, potatoes — which, imbedding 
the object swallowed, will carry it safely 

170 



EMERGENCIES 

through the intestinal tract, to be ejected 
without having done any harm. 

Burns. — Simple burns, where the flesh 
is merely scorched or only the outer layer 
of skin broken, may be made comfortable 
and effectually treated by laying on a little 
bicarbonate of soda (common baking soda). 
If that is not at hand, a soft linen or cotton 
cloth, spread with olive-oil, linseed-oil and 
lime-water, equal parts, vaseline, or sweet, 
clean lard, should at once be laid over the 
parts burned, then covered with cotton or 
numerous soft cloths to exclude the air. 
If the burns are more serious, a doctor's 
care is needed at once. If the accident 
happens at a time or in a place where it 
may be several hours before the physician 
can reach the child, much may be done in 
the mean time to relieve its sufferings. First 
cut all clothing from the child; do not at- 
tempt to remove it in any other way. Where 
burns are extensive, there is always more or 
less danger of blood-poisoning. This danger 
may be averted and great relief afforded to 
the patient if the wounds are treated in the 
following manner: Tear into strips about 
four inches wide and ten inches long clean 

171 



THE BABY 

pieces of old linen or cotton cloth; fold or 
roll these into small packages, and boil 
for fifteen or twenty minutes in a solu- 
tion of salt and water, two teaspoonfuls of 
salt to a quart of water; cool the water by 
placing the pail or other vessel in which 
the cloths have been boiled in a pan of cold 
or iced water; when lukewarm, wring out 
the cloths and lay two or three thicknesses 
over the entire surface which is burned; 
if the hands and feet are involved, care 
should be taken to place bits of linen be- 
tween the fingers and toes, and wrap up 
each member separately; over these wet 
compresses bind on thick layers of cotton, 
and over this oiled silk or even paper, as 
it is very essential to exclude all the air 
possible. Keep the patient quiet until the 
doctor arrives. 

Splinters. — A splinter is a very little 
thing, but capable of creating a great deal 
of mischief, discomfort, and pain. Every 
mother of small children should provide 
herself with a pair of small, sharp-pointed 
forceps for this emergency. When the 
splinter is imbedded in the flesh of hand or 
foot, the point of a small pair of scissors — 

172 



EMERGENCIES 

a manicure pair will very well answer the 
purpose — should be inserted directly over 
and following the path of the splinter, and 
a small incision made. If there be any 
bleeding, stanch it by a little pressure; 
then open the wound by stretching it a 
little, and with your forceps pick out the 
offending sliver. When the splinter is 
under the nail, cut a little V-shaped piece 




V 

V-SHAPED CUT FOR SPLINTER 

out of the nail, and with the forceps the 
splinter is easily removed. Protect the cut 
made with a little collodion or a finger- 
cot. 

Convulsions in Children. — A convulsion 
may mean serious brain trouble, but this 
is not true in the majority of cases. Con- 
vulsions in young children are more often 
caused by indigestion or an overloaded 

173 



THE BABY 

stomach than by anything else. In either 
case a doctor should be consulted as soon 
as possible. While waiting for him the 
mother may do much to relieve the child 
and quiet the spasm. Let her first thought 
be of what has gone into the child's stom- 
ach, also how long since there has been a 
movement of the bowels. Sometimes a 
small quantity of indigestible food will, 
in a short time, cause considerable dis- 
turbance. If the convulsions come from in- 
digestion, from an overloaded stomach or 
intestinal obstruction, immediate means of 
relieving these conditions should be taken. 
To relieve the stomach, vomiting may be 
induced by running the finger down the 
throat, or by a simple emetic, such as mus- 
tard and warm water; the bowels may 
be washed out by a high-up injection of 
warm soap and water. Cold applications 
should be applied to the head by means 
of cloths wrung out of ice-cold water, an 
ice-cap, or an ice poultice, made by crack- 
ing ice finely, mixing it with flax-seed 
meal or bran, and folding it in a piece of 
oiled-silk, which is then placed on the head. 
While the ice is being applied to the head 

174 



EMERGENCIES 

put the feet and legs in a mustard bath up 
to the knees. This may be done, while 
the child is lying on his back, by flexing 
the knees and placing the pail or foot-tub 
close to the thighs and putting the feet 
in. In this way the foot-bath is easily 
accomplished without disturbing the pa- 




FOOTBATH IN BED 



tient. The bath should be kept up until 
the extremities become well reddened; it 
is then removed and hot-water bottles 
placed at the feet. The temperature of 
the bath should be about I05 Q , and two 
tablespoonfuls of mustard should be added 
for every gallon of water. 

175 



THE BABY 

Frost-bites. — Frost-bites are less com- 
mon in babies than in older children, al- 
though I have known of a case where an 
infant had its cheeks frost-bitten in a brisk 
March wind, though the day was not very 
cold. The nurse, being young and healthy, 
enjoyed the walk, the fresh wind blowing 
in her face without doing the slightest 
harm, but the delicate cheeks of the baby 
suffered. In a case of this sort cold cloths, 
the colder the better, should be applied to 
the affected parts for five or ten minutes. 
When the ears, fingers, or toes are actually 
frozen or frost-bitten, use cold applications 
for the former, and dip the hands or feet in 
ice- water, or, if there is snow on the ground, 
rub these members with it or with a bit of 
ice. The frozen parts are always of a 
waxy whiteness in the beginning, but al- 
most immediately after coming in from 
the cold air they turn a reddish-purple 
hue, and begin to swell, and there is much 
pain. Use the cold application as soon as 
it is possible to do so. 

Bowel Troubles. — Summer diarrhoea, com- 
mon in infants and children, and which, 
if taken in time, can often be quickly ar- 

176 



EMERGENCIES 

rested, may, I think, be properly classed 
under the head of emergencies, especially 
during the summer, when the patient is 
away from home and his own physician, 
and perhaps many miles from any doctor. 
The chief causes of diarrhoea in children 
are improper food, like partly cooked ce- 
reals and vegetables, unripe or over-ripe 
fruit, milk which is not perfectly pure, 
sweet, or clean, thus containing poisonous 
bacteria, and cold which settles in the 
bowels. The first sets up a local irrita- 
tion which, if relieved in time and under 
proper treatment, may be stopped at the 
outset probably without further trouble; 
but which, if neglected and allowed to go 
on, or if improperly treated, may lead to 
serious consequences. Often the average 
mother, and occasioi-tally an inexperienced 
practitioner, will treat these attacks by 
giving a dose of paregoric or some of the 
hot patent mixtures concocted for summer 
complaint. Now, as a matter of fact, noth- 
ing could be more harmful or injurious or 
do so much to retard a quick recovery. 
Doses of this sort are positively danger- 
ous, and in giving them, instead of re- 
* 177 



THE BABY 

moving from the intestines the cause of 
the disturbance, you are taking every 
means to keep the irritant right there, to 
go on with its work of destruction. 

The opium which these concoctions con- 
tain may soothe and deaden the pain for 
a while, but the effect soon passes off, and 
the foreign element remains, to make mat- 
ters still more serious. In all these cases 
at the very outset a purgative should be 
given, and in many simple cases the treat- 
ment need not be carried further. Castor- 
oil is perhaps the safest in the hands of a 
novice; the oil is bland and soothing to 
the inflamed mucous membrane, and it is 
perfectly safe for the mother to give one, 
two, or three teaspoonfuls, according to 
the age of the child. This will act as an 
agent to carry off the poisonous or irritat- 
ing matter. If the attack is accompanied 
by fever, or, indeed, in any case, it is better 
to put the child to bed and keep him quiet 
for a day or two. Milk and solid food 
should be discontinued for a few days, 
gruels and broths being substituted. These 
gruels should be made of barley flour, 
wheat, farina, or arrow-root, and be thor- 

178 



EMERGENCIES 

oughly cooked. The broths may be of 
either mutton or chicken, made rich enough 
to jelly when cold. Beef juice may also be 
given when the symptoms of the disturb- 
ance pass off. If the patient is a baby, 
milk must be added to the gruels very slow- 
ly and gradually, commencing at first 
with as small a quantity as a teaspoonf ul 
to a bottle of gruel; if, as you proceed, the 
disease shows no signs of recurring, the 
food can be gradually brought up to its 
usual strength. In an older child, as the 
attack subsides and responds to treatment, 
the fluid diet may be followed at first by 
toast and a little raw beef. If the stools 
are very watery and frequent, give the 
child large quantities of water to drink; it 
is essential that the water be boiled and 
cooled. It is always safer to have a child 
wear a woollen abdominal band to prevent 
cold. 

Foreign Body in Nose or Ear. — Many 
children have the habit of pushing small, 
hard substances, as shoe-buttons, beans, 
01 peas into the ears or nostrils. A simple 
way to remove an object from the nose is 
to compress the side opposite the obstructed 

179 



THE BABY 

nostril, and make the child blow his nose 
violently. If he will not do so, induce a 
sneeze by tickling the nostrils with a feather, 
blade of grass, or some fluffy substance; 
if this will not answer, a little pepper or 
snuff should be used to accomplish this 
purpose, as a hard sneeze will probably 
remove the obstruction. If these should fail, 
the doctor should be called in. If the trouble 
is in the ear, it is a little more serious, and 
the object more difficult to remove. Ob- 
jects such as insects, bugs, beads, or small 
pebbles may be forced out by gently syr- 
inging the ear, or by pouring in a few 
drops of oil or glycerine. But if the object 
be large, and so tightly wedged in that it 
cannot be easily removed in this way or 
with the fingers, do not tamper with it, 
but take the child to a good otologist at once. 
If the object be a pea or bean, it is best not 
to syringe, as the water will cause either 
to swell and lodge itself more firmly in the 
passage, and considerable pain will follow 
in consequence. An old-fashioned and ex- 
cellent way to remove those obstructions 
which are in too far to be easily removed 
is to take a cameFs-hair brush, or a small 

180 



EMERGENCIES 

stick which has been tapered off almost to 
a point, and dip in some stout glue, touch 
this to the obstructing body, allow the 
glue to harden, then gently draw it out. 

Cuts and Bruises. — The best thing to do 
when there is a cut, large or small, is to 
cleanse the wound thoroughly, in order 
that dirt, particles of sand, or other matter 
may not remain to irritate and perhaps 
set up blood-poisoning; this can be done 
by holding the injured part under running 
water. Then bring the lips of the wound 
together and bind on a wet pad ; pressure 
will control the bleeding, and the chances 
are that the wound will heal without fur- 
ther trouble. If the wound is large enough 
to need stitches, it may be prepared in the 
same way until the doctor comes. If you 
wish to be very careful, use water boiled 
and cooled ; also boil the compress and 
bandage used. 

Where the wound is not only a cut but 
the flesh is also badly bruised, bind on cloths 
wrung out of a solution of boracic acid, one 
teaspoonful to a pint of water. Witch- 
hazel and plain boiled water are both good ; 
these applications should be cold. Do not 

181 



THE BABY 

smear vaseline, ointment, oils, or salves 
over the bruised flesh. 

In cases of severe bumps, where the flesh 
is not broken, alternate compresses of very 
hot and very cold water should be applied; 
cold will reduce the swelling, heat relieves 
the congestion, and a black-and-blue spot 
is the less likely to follow. 

Hiccoughs. — Infants are often subject to 
attacks of hiccoughs, and, while not serious, 
they are rather uncomfortable and dis- 
tressing. Hiccoughs are caused by a spas- 
modic contraction of the diaphragm, and 
a very simple means of relief is to place 
upon the end of the tongue a few grains 
of granulated sugar, which, as it dissolves, 
runs slowly down the throat. This or a 
few droppers' full of hot water given very 
slowly will usually cause a cessation of 
the paroxysms. 



INDEX 



Abdominal band, the, 54, 56, 179 ; how to put on, 57. 

Air, importance of fresh, 11-22, 143, 153, 154. 

Airing of infant, 13-16, 17-23. 

Albumen water, to make, 108. 

Amusement, infant, 69-80. 

Antitoxin, its use in cases of diphtheria, 141, 143. 

Apron, nurse's flannel, 42. 

Arrow-root water, to make, 107, 108. 

Artificial food, 81-113. 

Baby carriage, equipment of, 21-23. 

Baked apple, how prepared, 112. 

Band, abdominal, 54, 56, 179 ; how to put on, 57. 

Barley gruel, to make, 106. . 

Barrow-coat, 58. 

Basket, baby's, contents of, 40, 41. 

Bath, the, and bathing, 39-50 ; foot-bath, 175. 

Bath thermometer, 44. 

Bath-tubs, 41, 43. 

Beds, nursery, how to arrange, 32, 33. 

Bedsteads and cribs for nursery, 32. 

Beef, scraped, III. 

Beef juice, to make, no, ill. 

Beef pulp, to make, in. 

Beef tea, to make, no. 

Bicarbonate of soda, how to administer, 109. 

Bootees, 59, 60. 

Bottles, nursing, care of, 103-106. 

183 



INDEX 

Bowel troubles, causes and treatment of, 176— 179. 

Brain, growth of infant, 70, 73. 

Bronchitis, 19, 20. 

Broth, mutton,. how to make, 109, no; chicken, no. 

Bruises, treatment of, 181, 182. 

Bumps, treatment of, 182. 

Burns, treatment of, 171, 172. 

Carriage, baby, equipment of, 21—23. 

Castor-oil, its use in diarrhoea, 178. 

Chicken broth, to make, no. 

Chicken-pox, symptoms and treatment of, 159—161. 

Clothing, 50-62. 

Colic, cause and treatment of, 165, 166. 

Comfortables versus blankets, 56. 

Contagious diseases, their symptoms and treat- 
ment, 114— 161. 

Convulsions, cause and treatment of, 173—175. 

Cotton underwear versus silk or linen, 51, 52. 

Cough, see Whooping-cough. 

Cow's milk, preparation of, for infants' food, 81— 90, 
96-103. 

Crib-blanket, how to arrange, 30. 

Cribs for nursery, 32. 

Croup, symptoms and treatment of, 140, 162—165. 

Crying, when and why beneficial, 5—9. 

Cuts, treatment of, 181, 182 

Diapers, 29, 31, 60, 61. 

Diarrhoea, causes and treatment of, 176—179. 

Diet, for the healthy baby, 91—93 ; in whooping- 
cough, 155, 156 ; in mumps, 158 ; in chicken-pox, 
161 ; in diarrhoea, 178, 179. 

Digested gruels, 90 ; how to make, 106, 107. 

Diphtheria, symptoms and treatment of, 137—149. 

Diseases, contagious, symptoms and treatment of, 
114-161. 

184 



INDEX 

Disinfecting and fumigating rooms after measles, 123, 
124 ; after scarlet fever, 135, 136 ; after diphthe- 
ria, 141, 148, 149 ; after whooping-cough, 156. 

Draughts, danger of, 27-29. 

Dressing and undressing, 44, 45, 47. 

Dusting the nursery, 35. 

Ear syringe, rubber, 167. 

Earache, symptoms and treatment of, 132, 166, 167. 
Ears, how cleansed, 48 ; how to remove foreign sub- 
stances from, 1 79-18 1. 
Egg or albumen water, to make, 108. 
Emergencies, cases of, what to do in, 162—182. 
Essentials to baby's well-being, 5. 
Exercise, infant, 75. 
Eyes, how washed, 47. 
Eyesight, how to protect, 22, 23. 

Feeding, infant, 64, 81-113; intervals and formulas 

for, 93-99. 
Fever, scarlet, symptoms and treatment of, 124— 136. 
Food and feeding, 64, 81— 113. 
Foot-bath in bed, 175. 
Formulas for infant feeding, 96—99. 
Fresh air, how to obtain,and the effect of lack of, II- 

20, 24-31 ; in diphtheria, 142, 143 ; in scarlet 

fever, 154. 
Frost-bites, treatment of, 176. 
Fruit, stewed, 112. 
Furniture of the nursery, 32—37. 

Games, plays, etc., choice of, 79. 
Gargling the throat in scarlet fever, 131 ; in diph- 
theria, 146. 
Gruels, use of, and how to make, 89, 90, 106, 107. 

Handling the baby, why injurious, 9, 10, 44. 

185 



INDEX 

Hiccoughs, cause and treatment of, 182. 
Hunger, signs of infant, 8. 

Illness, signs of, 8. 

Infant feeding, formulas for, 96-99. 

Inhalation in whooping-cough, 152, 153 ; in croup, 

164. 
Intervals and formulas for infant feeding, 96-99. 

Lifting of the baby, 9, 10. 

Lime-water, how to make, 108, 109. 

Linen underwear versus cotton, 51. 

Long clothes, objection to, 59. 

Lungs of infant, how to strengthen, 5, 7, 11-22. 

Mattress for the nursery, proper, 33. 

Measles, symptoms and treatment of, 114— 124. 

Membraneous croup, 140. See also Croup. 

Milk, cow's, its elements and how to prepare for 

infants' food, 81-90, 96-103. 
Mittens, 22. 

Moderation, importance of, 3, 5, 7. 
Mortality, infant, 81. 
Mother, her need of moderation, 3, 5, 7 ; her duty to 

her offspring, 4-7, 61, 62. 
Motherhood, preparation for, neglected, 3—5. 
Mouth, how to wash infant's, 48. 
Mumps, symptoms and treatment of, 156—158. 
Mustard bath in bed, 175. 
Mutton broth, to make, 109, HO. 

Napkins, see Diapers. 

Nasal diphtheria, symptoms and treatment of, 139, 

140. 
Nervous diseases, cause and cure of, 3, 76, 77. 
Nipples, care of, 103—106. 
Nose, see Nostrils. 

186 



INDEX 

Nose-bleed, treatment of, 167, 168. 

Nostrils, how cleansed, 48 ; how foreign bodies are 
removed from, 179-181. See also Nasal Diph- 
theria. 

Nurse, the, mother should be independent of, 4 ; in 
scarlet-fever cases, 133—135. 

Nursery, the, 24—38 ; heating and ventilation of, 
24—31 ; furnishings of, 31—35 ; cleaning and car- 
ing for, 35-38. 

Nursery-maid, qualifications of, 37, 38, 77. 

Oatmeal gruel, to make, 106. 

Oatmeal porridge, to make, 113. 

Orange juice, how prepared, 113. 

Outings, infant, 20-22. 

Overheated and closed rooms, danger of, 19, 20. 

Over-indulgence in infancy, 6. 

Over wrapping, ill effects of, 20-22, 53. 

Pasteurizer, home-made, and how to pasteurize milk, 

IOI-103. 
Petticoats, 55, 56. 

Pictures, stories, and rhymes, choice of, 78, 79. 
Pins, use of, condemned, 54, 57. 
Plays, games, etc., choice of, 79. 
Pneumonia, 19, 20, 144. 
Porridge, oatmeal, how to prepare, 1 13. 
Prunes, stewed, 112. 
Purgatives, see Bowel troubles. 

Rhymes, stories, and pictures, choice of, 78, 79. 

Rice gruel, 106. 

Rocking the baby, 6, 8, 65, 71. 

Romping, time for, 75. 

Sand-beds, children's use of, 77, 78. 
Scarlet fever, symptoms and treatment of, 1 24-136. 

187 



INDEX 

Scraped beef, to make, ill. 

Screen, nursery, 28. 

Shirt, infant, 57, 58. 

Shoes, 59, 60. 

Sick-room, management of, In measles, 1 19, 120, 

123, 124; in scarlet fever, 129-131, 133-135; 

in diphtheria, 147, 148; in whooping-cough, 

154-156. 
Six essentials to the baby's well-being, 5. 
Sleep and sleeping habits, 63—69. 
Soap for baby's bath, 50. 
Spanking, the baby's first, 5. 
Splinters, removal of, 172, 173. 
Spoiling the baby, 70-72, 75, 76. 
Sponge bath, the, 49. 
Sponges, objection to use of, 50. 
Sterilization of milk, 99, 100 
Stewed fruit, 1 12. 
Stewed prunes, 112. 
Stockings versus socks, 59. 
Stomach troubles, 165, 166, 170, 174, 176-179. 
Stories, pictures, and rhymes, choice of, 78, 79. 
Swallowing of foreign substances, how to treat 

children in case of, 168— 171. 
Syringing the throat in diphtheria, 146; the ear 

in earache, etc., 167, 180. 

Temperature, suitable for an airing, 14— 16, 19; of 
the nursery, 26, 2j, 53 ; of the bath-room, 40 ; 
of the bath, 43 ; of the sick-room in case of 
measles, 120; in case of scarlet fever, 130; of 
foot-bath, 175. 

Throat and lung troubles, 11-22, 137-158; how to 
examine the throat, 137, 138, 151. 

Tonsilitis, 140. 

Undergarments, 51-56. 

188 



INDEX 

Veiling infant's face, effects of, 23. 

Ventilation, how to obtain and the evils of lack of, 

11-20, 24-31, 142, 143, 154. 
Vomiting, to induce, 174. 

Walking the baby, 6, 8, 65, 71. 

Walls, nursery, 33, 34. 

Wardrobe, baby's, 50—62. 

Washing the baby, 39-52. 

Wheat gruel, 106. 

Whooping-cough, symptoms and treatment of, 

149-158. 
Woollen underwear, advantages of, 52. 
Wraps for baby's outings, 20-22. 



THE END 



By M. E. W. SHERWOOD 



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